Implementação de Prontuário Eletrônico por profissionais médicos e enfermeiros da Atenção Primária à Saúde / Implementation of Electronic Medical Records by physicians and nurses in Primary Health Care

Objetivo: Avaliar a implementação o Prontuário Eletrônico do Cidadão da estratégia e-SUS na Atenção Primária a Saúde pelos médicos e enfermeiros de duas macrorregiões de saúde de Minas Gerais. Métodos: Estudo de método misto explanatório sequencial quanti-qualitativo. A coleta de dados ocorreu por meio de um formulário online. Foi construída uma matriz de análise e julgamento para avaliar e ponderar as questões avaliativas no instrumento de coleta. Resultados: De maneira geral, o grau de implementação de cada uma das funcionalidades (assistenciais e gerenciais) foi classificado como não adequado, mas há diferença quando se compara as profissões. Os dados mostram que a medicina quando comparada com a enfermagem tem a utilização do prontuário com escore menor, indicando que médicos informaram usar menos o prontuário eletrônico do que os enfermeiros. Conclusões: Apesar dos grandes esforços governamentais para expandir a implantação do prontuário eletrônico, sua implementação, de forma geral, ainda não é adequada. Dessa forma, a utilização do prontuário eletrônico como potencial qualificador de dados em saúde deve ser estimulada em direção à gestão e coordenação do cuidado(AU)

Objective: To evaluate the implementation of the Electronic Citizen's Record of the e-SUS strategy in Primary Health Care by physicians and nurses from two health macro-regions in Minas Gerais. Methods: Estudio de método mixto explicativo secuencial cuantitativo-cualitativo. Data collection took place through an online form. An analysis and judgment matrix were built to evaluate and weigh the evaluative questions in the collection instrument. Results: In general, the degree of implementation of each of the functionalities (assistance and management) was classified as not adequate, but there is a difference when comparing the professions. The data show that medicine, when compared to nursing, uses the medical record with a lower score, indicating that physicians reported using the electronic medical record less than nurses. Conclusions: Despite major government efforts to expand the implementation of electronic medical records, its implementation, in general, is still not adequate. Thus, the use of electronic medical records as a potential qualifier of health data should be encouraged towards the management and coordination of care(AU)

Objetivo: Evaluar la implementación del Registro Ciudadano Electrónico de la estrategia e-SUS en la Atención Primaria de Salud por médicos y enfermeros de dos macrorregiones de salud de Minas Gerais. Métodos: La recolección de datos se realizó a través de un formulario en línea, se construyó una matriz de análisis y juicio para evaluar y ponderar las preguntas evaluativas del instrumento de recolección. Resultados: En general, el grado de implantación de cada una de las funcionalidades (asistencia y gestión) fue catalogado como no adecuado, pero hay diferencias, al comparar las profesiones. Los datos muestran que la medicina, en comparación con la enfermería, utiliza la historia clínica con una puntuación más baja, lo que indica que los médicos utilizan menos la historia clínica electrónica que las enfermeras. Conclusiones: A pesar de los grandes esfuerzos gubernamentales por ampliar la implementación de la historia clínica electrónica, su implementación, en general aún no es adecuada. Por lo tanto, se debe fomentar el uso de la historia clínica electrónica como potencial calificador de datos de salud para la gestión y coordinación de la atención(AU)

Prontuário eletrônico de pacientes: integrando informações clínicas e imagens médicas / Eletronic patient record: integrating clinical information and image data

O Instituto do Coração tem envidado esforços para integrar todas as informações clínicas dentro da Instituição. Nos últimos anos o InCor implementou com sucesso um sistema para transmissão, arquivamento, recuperação, processamento e visualização de Imagens Médicas e um Sistema de Informações Hospitalares (HIS) que armazena as informações administrativas e clínicas. A integração desses subsistemas forma o Prontuário Eletrônico do Paciente (PEP). O InCor é um dos seis Institutos que compõem o Hospital das Clínicas da Universidade de São Paulo. Como cada um dos Institutos possui o seu próprio sistema de informações, a troca de informações entre os Institutos é também uma questão muito relevante. Este trabalho apresenta a experiência no desenvolvimento de um Prontuário Eletrônico funcional e completo, que inclui controle de acesso, exames laboratoriais, imagens (estáticas, dinâmicas e 3D), laudos, documentos e mesmo sinais vitais de tempo real. Este artigo também discute a modelagem e implantação de um protótipo de um PEP distribuído e homogêneo. Atualmente, um volume superior a 2,5 TB de imagens DICOM já foi armazenado utilizando a arquitetura proposta. Diariamente, o PEP armazena mais de 5GB de dados e tem uma quantidade de acessos superior a 300 usuários. O sistema de armazenamento permite uma visibilidade de seis meses para acesso imediato e mais de dois anos para acesso automático utilizando uma jukebox

The Heart Institute (InCor) of São Paulo has been committed to the goal of integrating all clinical information within the institution. In the last few years, InCor has successfully created a system for transmission, archiving, retrieval, processing and visualization of Medical Images and a Hospital Information System (HIS) that stores the institution administrative and clinical information. These integrated subsystems form InCor's Electronic Patient Record (EPR). Since InCor is one of the six institutes of the University of São Paulo Medical School Hospital (HC) and each institute has its own information system, exchanging information among the institutes is also a very important issue. This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes access control, lab exams, images (static, dynamic and 3D), clinical reports, documents and even real-time vital signals. This paper addresses also the design and prototype for integration of distributed and heterogeneous EPR. Currently, more than 2.5 TB of DICOM images, have been stored using the proposed architecture. The EPR stores more than 5 GB/day of data and presents more than 300 hits per day. The proposed storage subsystem allow six months of visibility for rapid retrieval (online mode) and more than two years for automatic retrieval using the jukebox

Cost-Benefit Analysis of the Sharing System for Electronic Patients Records Among Healthcare Institutions / 대한의료정보학회지

In 2000, Korea Health Industry Development Institute(KHIDI) made a plan for sharing electronic patient records between health care institutions which reflects the advance of information technology. The implementation of the plan is believed to have a number of desirable effects such as direct and indirect medical cost savings, the increase in patient satisfaction, the rationalization of health care institution management, and the improvement of health care delivery system. At the same time, however, it requires a great amount of resources for building the system at first and maintaining it since then nationwide. Therefore, the economic evaluation is required for the plan to be undertaken. This paper assessed the plan from economic perspective. In particular, cost-benefit analysis was performed and the result showed that the present value of net benefit, or the social profit is 3,046.3 billion won over the period of 2000-2030. Also, the benefit-cost ratio turned out to be 1.25. The results of cost-benefit analysis confirmed that the benefits of the plan justify the costs.

Economic Analysis of Electronic Patient Record / 대한의료정보학회지

This study was carried out to analyse the economic feasibility of EPR. A hospital with 500 beds under the construction was selected for this study. The economic effect was performed with cost-benefit analysis for 5 years from the year 1998 to 2002. The results of this study were as follows; The economic effect of EPR was classified into direct benefit, value acceleration, and value linking. Each factor was applied and analyzed step by step. In the analysis including only direct benefit, the net present value and the ratio of benefit to cost were minus 82,920,000 won and 0.8. With this traditional cost-benefit analysis alone, the EPR in hospital can be regarded as very unprofitable. However, when value acceleration was added, the net present value and the ratio of benefit to cost rose to 748,637,000 won and 2.7 respectively. Moreover, when value linking was added, the net present value and the ratio of benefit to cost were 1,473,162,000 won and 4.3, respectively. In the results of this study, as EPR has only direct benefit, EPR can be regarded as unprofitable project. However, when value acceleration and value linking were added, EPR can be profitable project.

AI aided electronic patient records for large intestinal tumors and their management / 中华医院管理杂志

Objective To explore new ways of scientifically collecting and processing clinical information and improve the efficiency of computer management of electronic patient records for large intestinal tumors. Methods An elementalized and standardized analysis and decomposition was made of the information presented by cases of large intestinal tumors and AI aided tabular electronic patient records for large intestinal tumors were designed using the software of Microsoft Access 2000 and compared with the current Word file records. Results A computer management system of electronic patient records for large intestinal tumors was created, with the linkage of the record elements and the electronic tables of the database. Both the speed and quality of patient information input were markedly enhanced. Conclusion AI aided tabular electronic patient records for large intestinal tumors, which are faster and more exact than the Word file records, are beneficial for the speedy input, statistical analysis and AI aided management of clinical information.