Kugwiritsa ntchito mwayi watsopano wothandizira odwala komanso kuchita nawo mbali wakhala mbali yofunikira ya chithandizo chamankhwala chamakono. Izi zikuwongoleranso njira yomwe timayendera ndi kupewa matenda. Anthu omwe akufulumira kugwiritsa ntchito njira zatsopano zaumoyo-onse odwala komanso ogwira ntchito kuchipatala-adzawona kupindula kwambili ndi kupita patsogolo kumeneku.
Mipata mu Electronic Health Adoption Kulandira
Mauthenga a zamakono a Ethernet (EHRs) akuwonjezereka kwambiri ku United States, zomwe zikugwirizana ndi Health Information Technology for Economic and Clinical Health Act (HITECH Act) yomwe idaperekedwa mu 2009.
Lamulo limeneli limagwiritsa ntchito kugwiritsa ntchito zipangizo zamakono zogwiritsira ntchito zogwiritsira ntchito zaumoyo ndikuthandizira kukhazikitsa EHRs. Poyamba, zopereka zachuma zinaperekedwa kwa ogwira ntchito ogwiritsira ntchito EHRs, ndipo zinanenedweratu kuti pakalipano polojekitiyo idzatha. Mu lamulo loyambirira la HITECH, zilango zomwe zingatheke zingakhale zochitika ndi mabungwe osamalira zaumoyo osati kusonyeza kugwiritsa ntchito zamakono zamakono zamakono zam'chipatala pambuyo pa 2015. Komabe, kukhazikitsidwa kwa pulogalamuyo kwacheperapo kusiyana ndi kuyembekezera, choncho mu 2014, Centers for Medicare ndi Medicaid Services (CMS) adalengeza kuti gawo lachitatu la ndondomeko ya kukhazikitsidwa komaliza linathetsedwa mpaka 2017. Chaka chatha, kugwiritsa ntchito moyenera EHRs kunasankhidwa kwa onse opereka. Mu 2018, kukhazikitsidwa kwa gawo lachitatu la ndondomeko yoyendetsera polojekiti kunapangidwira. Magulu ena, adapempha kuti siteji 3 iwonzedwe kachiwiri chifukwa cha kukonzekera komweku pakati pa opereka ndi ogulitsa.
Komabe, pakhala kuwonjezeka kwakukulu kwa kugwiritsa ntchito EHRs. Kafukufuku amene adachitika mu 2013 ndi Michael Furukawa ndi olemba anzawo apeza kuti 78 peresenti ya madokotala omwe akugwira ntchito paofesiwa tsopano adalandira mtundu wina wa EHR. Kuchuluka kwa chiwombankhanga kunali kochepa m'magulu amodzi okhazikika komanso zosamalidwa zapadera, kusonyeza kuti palibenso mwayi wopititsa patsogolo anthu ambiri.
Kusanthula deta kwa Furukawa kunasonyezanso kuti kugwiritsa ntchito njira zogwiritsira ntchito zamakono zamakono kungachepetse zochitika za mankhwala osokoneza bongo kuchipatala, monga zolakwika za mankhwala, overdoses ndi zotsatira zolakwika. M'nkhani yomwe inalembedwa mu 2017 mu Journal of the American Medical Informatics Association, Furukawa ndi anzake adanena kuti kuchepa kwa 20 peresenti ya zochitika za mankhwala osokoneza bongo kungakhale chifukwa cha kugwiritsa ntchito moyenera kwa EHRs. Zomwezi zingapangitse zipatala zambiri kuti zikhale ndi EHRs komanso kuchepa kwa madokotala zomwe zikugwiritsabe ntchito mogwira mtima.
Mwaphonya Mipata
Kulephera kukwaniritsa EHRs si vuto lokha limene limaletsa chithandizo chamankhwala. Deta yosonkhanitsidwa ku EHRs ili ndi mphamvu zambiri kuposa zomwe zikugwiritsidwa ntchito panopa. Pamene machitidwewa athandizidwa kuti agwirizanitse mitundu yambiri ya chidziwitso, iwo ali okonzeka bwino kupanga zowonongeka zokhudzana ndi momwe wodwalayo angayankhire.
Kafukufuku wochuluka anayesera njira imeneyi pa chisamaliro cha shuga. Pamene EHRs idaphatikizidwa ndi njira zamagetsi, njirayi inkawonetsedwa kuti ikuposa zomwe zikuchitika masiku ano. Kusonkhanitsa deta yaumwini ndi kulosera zamatsenga kunaposa kupambana kwa njira zambuyomu.
Zinapereka kutanthauzira kwabwino kwa chidziwitso cha odwala komanso ndondomeko yabwino yosamalira. Kafukufuku wochitidwa ndi Dr. Michael Klompas wa Harvard Medical School ndi Harvard Pilgrim Health Care Institute ku Boston anapeza kuti ma EHR deta angathandize kuzindikira matenda ambiri a shuga ndikusankha pakati pa mtundu wa 1 ndi mtundu wa shuga. Klompas ndi gulu lake amakhulupirira kuti luso lamakonoli likhoza kukhazikitsidwa ngati chithandizo chodziwika bwino chaumoyo wa anthu ndipo lingathandize pa kayendedwe kachitidwe ndi olemba odwala pa maphunziro a zachipatala.
Ndi EHRs zamakono, zowonjezereka zitha kuwonetsedwa mosavuta ndi kupereka gulu lachipatala ndi malangizo othandizira otsogolera ndi odwala omwe ali oleza mtima ndipo amasinthidwa kwa wodwala.
Chimodzi mwa zifukwa za machitidwe ochiritsira anthu ndizokuti njira zowonongeka motsutsana ndi chiyero choyambira zimachokera ku generalizations za anthu. Njira imeneyi ndi yolemekezeka kwambiri chifukwa chokhala ndi zofuna za munthu. Kuwonjezera apo, ndondomeko yovomerezeka ya deta yolumikiza deta imatsimikizira kuti ndondomeko ya chisamaliro cha munthuyo ndi yozikidwa pamaganizo komanso yomveka. Malangizo ndi ndondomeko zimasinthidwa nthawi zonse, zomwe zimathandiza kusamalidwa ndi kusasamala komwe kumagwirizana ndi zosowa za wodwalayo. Palinso umboni wochuluka wokhudzana ndi EHRs ndi njira zothandizira chisankho (CDSSs) zingasinthe kusintha kwa thanzi ndikusintha deta yomwe ikupezeka muzomwe mungachite.
Kakompyuta Yothandiza Odwala
Mu 2015, IBM ndi CVS Health analengeza kugwirizana kuti agwiritse ntchito mphamvu yaikulu yowonongeka ya makompyuta a IBM Watson kuti athandize makasitomala a CVS. Chiyanjano chimapangitsa CVS kudziwa bwino ogula omwe angakhale pachiopsezo cha zotsatira za thanzi labwino ndikupereka ntchito zowonjezera kwa iwo omwe amachulukitsa zovuta zowonjezera moyo wawo.
Watson Oncology, njira yatsopano yolumikizirana, tsopano ikugwiritsidwa ntchito ndi Memorial Sloan Akuchipatala kutanthauzira deta ya odwala khansa ndikupeza chithandizo chabwino kwambiri pogwiritsa ntchito luso la kusungidwa ndi kufufuza. Izi zikutanthauza kuti umboni watsopano ukhoza kuyenda mofulumira kupyolera mu malo owonetserako zaumoyo komanso kusintha chisamaliro cha odwala. Komanso, zimathandizanso kudziwa zambiri kuchokera kwa katswiri wina kupita kwina. Izi zikhoza kuonetsetsa kuti mumalandira chisamaliro chimodzimodzi pamtundu uliwonse ngakhale kuti dokotala wanu ndi ndani. Kusunthira kuwonjezera zinthu zowonongeka kuchokera pa deta yaumoyo wodwala wodwala kungakhale mwatsatanetsatane ndi ochita mpikisano, ndipo ndi chiyambi chabe choonjezera kugwiritsa ntchito nzeru zamakono kuti zithandize thanzi la anthu. Kuyanjana pakati pa makampani ngati IBM ndi makampani azachipatala ndi mankhwala akhoza kuonetsetsa kuti zatsopano zimagwiritsidwa ntchito pa chithandizo chamankhwala tsiku ndi tsiku mofulumira.
Odwala Akudzithandiza
Mpata wina wawukulu woperekedwa ndi digito ya zamagetsi zamakono ndi mwayi wowonjezera wodwalayo. Odwala tsopano angayang'ane, kukopera ndi kupeza mauthenga awo a umoyo, komanso kupanga zisankho zolondola pazochita zawo. Michael Furokawa ndi gulu lake la kafukufuku anapeza kuti madokotala amagwiritsira ntchito kwambiri zipangizo zamakono kuti agaŵane zambiri ndi odwala awo. Mu 2014, 30 peresenti ya omwe adafukulidwa madokotala nthawi zonse ankatha kugwiritsa ntchito mauthenga otetezedwa, ndipo 24 peresenti amapatsa odwala kupeza mauthenga a paumoyo wawo pa intaneti. Nambalayi mwachionekere yakula kwambiri m'zaka zapitazo ndipo mwinamwake yowonjezera mgwirizano wothandizira odwala.
Njira zatsopano zikugwiritsidwa ntchito nthawi zonse kuti zowonjezera odwala pogwiritsa ntchito zipangizo zamakono. Mercy -a thanzi labwino lomwe limakhala ndi matenda aakulu omwe amapanga mapulogalamu aŵiri-pulogalamu yamakono ndi aphunzitsi awo a zaumoyo. Makolo amagwiritsa ntchito matekinoloje kuti athandize odwala kuti azidziyesa okha ndikudziphatika kwambiri paokha. Mwanjira iyi, teknoloji yokha si yankho. Kulumikizana kwaumunthu kumathandiza kusintha maganizo ndikusintha kusintha kwa khalidwe, pamene teknoloji ikukulitsa zotsatirazi. Kuyanjana kwa anthu kungapitirizebe kukhala chinthu chofunikira ndikukhalabe wotsimikizika ponena za kupambana kwa zotsatira zaumoyo, monga momwe kusinthika kwa teknoloji kumatithandiza kusintha njira zomwe zikufulumizitsa ndikukula patsogolo kupita patsogolo kwabwino.
> Zosowa
> Furukawa M, King J, Patel V, Chun-Ju H, Adler-Milstein J, Jha. Health , 2014; 33 (9): 1672-1679
> Furukawa M, King J, Patel V. Wodwala malingaliro kuti athe kugwiritsa ntchito ntchito za EHR zokhudzana ndi kugwiritsa ntchito moyenera. Magazini Achimereka Yokhudza Kusamalidwa , 2016; 21 (12): E684
> Furukawa M, Spector W, Limcangco M, Encinosa W, Rhona Limcangco M. Kugwiritsira ntchito mogwira mtima zipangizo zamakono zamakono komanso kuchepa mu zochitika zowononga mankhwala. Journal of the American Medical Informatics Association , 2017; 24 (4): 729-736.
> Klompas M, Eggleston E, McVetta J, Lazaro R, Li L, Platt R. Odzidziwitsidwa ndi mtundu wa mtundu wa mtundu wa 1 wotsutsana ndi mtundu wa shuga 2 pogwiritsa ntchito deta yachuma. Chisamaliro cha shuga . 2013; 36 (4): 914-921.