Iimvavanyo kunye neengxaki ze-EMR kunye nee-EHR
Iirekhodi zezobisi zonyango ezibhalwe ngamagama zinikezela ngokuchanekileyo iirekhodi zonyango ze-elektroniki (EMRs). Nangona iirekhodi zezobugcisa zedijithali sele zijikeleze ubuncinane ubuncinane iminyaka engama-30, utsalo-mali olubonakalayo oludlulileyo kule minyaka elishumi edlulileyo luye lwaphumela ekuphatheni kwedatha nokufikeleleka okwangaphambili akufumanekanga. Ukukhawuleza kwezinto ezintsha kunye nenkqubela ye-EMRs iya kwanda, nangona kunjalo, kusekho iingxaki ezininzi zokunqoba.
Ukuphunyezwa kweenkqubo ezintsha zedatha yezokwelapha kuye kwafumana ukugxekwa kwiinkcukacha zonyango kunye neempendulo kubabungqina babo obonakala bengenakuphendula nokuxhobisa.
EHR vs. EMR
Ezi zimbini ze-acronyms-EHR kunye ne-EMR-zihlala zisetyenziswa ngokungafaniyo. Kodwa njengoko i-Ofisi yoMququzeleli weSizwe wezoLwazi lwezeMpilo (i-ONC) ibhala, kukho umehluko phakathi kwamarekhodi ezempilo ze-elektroniki (EHRs) kunye nee-EMRs. Ii-EMR zangaphambi kwe-EHR kwaye zenzelwe ukuba ugqirha basebenzise kuphela. I-EHR izama ukuqhubeka kwaye iquka uluhlu olubanzi lweedatha kune-EMRs.
Ukusetyenziswa okunenjongo-isethi yemigangatho efunekayo ukuqinisekisa ukuba i-dollar zemali esetyenzisiweyo kwi-EHR ziphumela kwiziphumo ezivelisayo-ngokusemthethweni izigunyaziso zokuthi i-EHR ingabandakanyeka. Lo myalelo udinga ukuvula idatha yezempilo kunye nokudibanisa iinkqubo ezahlukileyo ezidala "imimiselo emininzi" (ngokuchaseneyo ne "point point to point" model) yenzelwe ukwandisa ukusetyenziswa kweenkcukacha zonyango.
Nangona kunjalo, uFred Trotter, umgcini-nkcukacha we-data-journalists kunye nombhali, uthi i-EHR ayakwazi ukutshintshisiswa kwedatha kunye nokunxibelelana, ngoko ke inkqubo yokunakekelwa kwempilo yaseMerika inokuthi ikhona ngexesha le-EMRs.
Yintoni ekhusela inkqubo yokusetyenziswa kwezempilo?
UDkt. Karen DeSalvo, owayengumNxibelelanisi kaZwelonke wezoLwazi lwezeNkcukacha zezeMpilo, wabhala malunga nezikhalazo "zokuthintela ulwazi lwezempilo." Lo mkhuba ukhubaza ukutshintshisiswa kunye nokusetyenziswa kolwazi lwezempilo lwekhompyutha kwaye yenye yeengxaki zokungasebenzi.
Nangona ininzi yezobugcisa bezedijithali ixhasa injongo yolwabelana ngolwazi oluya kuphucula unyango lwezempilo kwaye ulondoloze imali, u-DeSalvo uthi, "abanye abathathi-nxaxheba kwiinkampani zempilo kunye nezempilo ze-IT banomtsalane oqinileyo wokulawula ulawulo lwezempilo."
Ngo-Ephreli 2015, i-ONC ithumele ingxelo kwiCongress ngolwazi lokuthintela, kunye nabalobi abacetywayo izenzo ezinokubamba umkhwa wokusebenza, kwaye kuchazwe ukuba kufuneka kube lula ngakumbi kwiimarike ze-IT.
Ucwaningo lwesizwe olwenziwa nguJulia Adler-Milstein no-Eric Pfeifer weYunivesithi yaseMichiganzi Izikolo zeeNkcukacha kunye neMpilo kaRhulumente zibonise ukuba ukukhutshwa kolwazi kusasazeka ukusasazeka. Abaphenduli babika ukuba abathengisi, izibhedlele kunye neenkqubo zezempilo zihlala zibandakanya ulwazi lokuvimba. Ukungasebenzisani ngokukodwa kweemveliso kwakungenye yeendlela eziqhelekileyo zolu hlobo kubathengisi. Izibhedlele kunye neenkqubo zezempilo, ngandlela-thile, zazifunyanwa ukuba zinikeze unyango olukhethekileyo kuhlobo oluthile lwe-EHR kunye nabanikezeli abaxhasiweyo ukuba bawamukele. Abaphenduli nabo babone izibhedlele ezilawula ukugeleza kwezigulane ngokungabelana ngolwazi lwabo ngokuvulekileyo.
I-Purportedly, i-motivation emva kwezinto ezinjalo kwakunomnqweno wokwandisa imali. U-Adler-Milstein no-Pfeifer bakholelwa ukuba ukukhutshwa kolwazi kufuneka kungabi mthethweni, oku kuquka ukufaka umthetho omtsha kwindawo yokuchonga idatha kunye nokwabelana.
Omnye umqobo okhankanywe ekusebenzisaneni kwe-EMR ephumelelayo ngumxube odibeneyo wemiba yezobuchwepheshe kunye nokusebenzisana komgaqo-nkqubo. Ukubhenela izibhedlele ukuba zidale indima ezinikeleyo ekujonganeni nale micimbi ekhethekileyo.
Konke kuzo, ukusebenzisana kusele mngeni. Abaninzi abanonophelo lwempilo bakholelwa ukuba izithintelo zokuphunyezwa kwayo azange zisuswe naphezu kwazo zonke iinjongo zokuqala kunye nezibonelelo ezifakelwe kule projekthi.
Ukunyuka kwe-EMRs
Ukuphatheka kweenkcukacha zempilo yomntu omnye umgaqo obalulekileyo ohambelana nokudala imigaqo phakathi kwe-syntax esetyenziselwa ukudala iirekhodi zempilo kunye nokukwazi ukuthutha le nkcukacha kwiinkqubo ezingafaniyo. Uphando oluninzi lubonise ukuba idatha ephathekayo kwaye idluliselwe kalula ikwazi ukuphucula kakhulu iinkonzo zonyango kunye nokunyusa ukunakekelwa kwezigulane. Nangona kunjalo, ukuphatheka kwe-EMRs ngumceli-mngeni ongeke uxazululwe kodwa kusenokwenzeka ukuba ulungele ukufezekiswa kwenkqubo yokunakekelwa kwempilo.
Ukwabelana ngokukhuselekileyo nokukhuselekileyo kolwazi lwezempilo lwedijithali luhlala lulodwa lwezinto eziphambili kwi-digital health movement. Abaphandi baseIndiya abavavanya ukuphunyezwa kwe-EHR kumazwe asakhulayo baye bacetyiswa ukuba ukugcinwa kwefu, ukukhuselwa kwephasiwedi, kunye nokubethelwa kwazo zonke iinkqubo zonyango zononophelo zingathatha ukwenza ii-EHR eziphathekayo zikhuseleke ngakumbi. Ezinye izikhuselo zokhuseleko kunye neendlela zokuziphatha ezibhalwe phantsi ziye zabhalwa kwaye ezi zihlandlo ziye zafaka ubungakanani be-EHR.
Impilo yokuvala IT ikhefu
Ukuqhubela phambili ukwabelana ngolwazi ngempilo, ngoJulayi 28, 2015, i-ONC yamemezela ngaphezu kweerandi ezingama-38 kwizibonelelo zonikezelo-mali kwimibutho engama-20 evela kumazwe angama-19 kulo lonke ilizwe. Enye into efunyenwe ukuba ibhaso lisebenze kuyo yandisa ukuhlanganiswa kolwazi lwezempilo. Inkqubo yezempilo yoluntu kwiprogram yokufunda ngoontanga nayo yaxelwa ukunceda uluntu luphuculise i-aggregation data, ukuchithwa kwedatha nokuhlaziywa kwedatha, bonke ngenjongo yokuphumeza iziphumo ezingcono kunye nokunyamekela kwezempilo.
Ezinye iiprogram ziye zafakwa ukuba zibandakanye izigulane kwaye ziphucule ukulungelelaniswa kwenkathalo, njenge-Medicare ne-Medicaid EHR Incentive Programs. Ezi nyathelo zikhuthaza ukutshintshiselwa kolwazi lwezempilo olukhuselekileyo. Bakhuthaza nokufikeleleka kwezigulane kwiirekhodi kunye nezixhobo zecomputer ukwenzela ukunxibelelana nabaninikeli bezempilo. Injongo epheleleyo yenkqubo kukunciphisa ukungalingani kwempilo kwaye inikezele ngononophelo olumgangatho woluntu ngoncedo lwethekhnoloji. Uvavanyo olutsha nje lwenkqubo ye-EHR Inkqubela yeSebe lezeMpilo neLwazi loLawulo lweKholeji yaseSt. Scholastica lubonise ukuba kukho ukuqhubela phambili. Nangona kunjalo, ukwenzela ukuba ube ngumxhasi ophezulu kumxhasi kwaye uphucule iziphumo zononophelo kubo bonke, ukubandakanyeka komsebenzisi kusenokufuna ukunwa kwangakumbi.
> Imithombo
> Adler-Milstein J, uPfeifer E. Uvimba oLwazi: Ngaba lwenzeka kwaye yiyiphi i-Strategies Strategies Can Address It? . I-Milbank ngekota . 2017; (1): 117-135
> U-Ozair FF, iJamshed N, i-Sharma A, i-Aggarwal P. Imiba yokuziphatha kwiirekhodi zezempilo ze-elektroniki: Umboniso jikelele. Iimpembelelo zoPhando lwezonyango . 2015; 6 (2): 73-76
> Terry K. Usalindela: kutheni u-EHR ukusebenzisana kusenokuba ngumgomo ongekho. Uqoqosho lwezeMpilo . 2017; (11): 14-19.
> I-Trotter F. Yintoni enokuyisebenzisa ngokufanelekileyo Funda kwi-Healthcare.gov ?. I-Blog Care Blog , Matshi 2, 2015. http://thehealthcareblog.com/blog/2015/03/02/what-can-meaning-use-arning-from-healthcare-gov
> I-Watters A, i-Bergstrom A, i-Sandefer R. Ukubandakanya isigulane kunye nokusetyenziswa okubalulekileyo: Ukuvavanya impembelelo yeprogram ye-EHR yokukhuthaza inkcubeko kwiinkonzo zempilo. Umbhalo weeNkcubeko ezahlukeneyo . 2016; 23 (3): 114-120.