Informatics as Tool for Quality Improvement: Rapid Implementation of Guidance for the Management of Chronic Kidney Disease in England as an Exemplar / 대한의료정보학회지
Healthcare Informatics Research
;
: 9-15, 2013.
Article
Dans Anglais
| WPRIM
| ID: wpr-105237
ABSTRACT
OBJECTIVES:
Chronic kidney disease (CKD) is an important cause of excess cardiovascular mortality and morbidity; as well as being associated with progression to end stage renal disease. This condition was largely unheard of in English primary care prior to the introduction of pay-for-performance targets for management in 2006. A realist review of how informatics has been a mechanism for national implementation of guidance for the improved management of CKD.METHODS:
Realist review of context, the English National Health Service with a drive to implement explicit national quality standards; mechanism, the informatics infrastructure and its alignment with policy objectives; and outcomes are describe at the micro-data and messaging, meso-patient care and quality improvement initiatives, and marco-national policy levels.RESULTS:
At the micro-level computerised medical records can be used to reliably identify people with CKD; though differences in creatinine assays, fluctuation in renal function, and errors in diabetes coding were less well understood. At the meso-level more aggressive management of blood pressure (BP) in individual patients appears to slow or reverse decline in renal function; technology can support case finding and quality improvement at the general practice level. At the macro-level informaticians can help ensure that leverage from informatics is incorporated in policy, and ecological investigations inform if there is any association with improved health outcomes.CONCLUSIONS:
In the right policy context informatics appears to be an enabler of rapid quality improvement. However, a causal relationship or generalisability of these findings has not been demonstrated.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Soins de santé primaires
/
Qualité des soins de santé
/
Pression sanguine
/
Informatique médicale
/
Dossiers médicaux
/
Systèmes informatisés de dossiers médicaux
/
Saccharose alimentaire
/
Créatinine
/
Informatique
/
Diabète
Type d'étude:
Guide de pratique
/
Étude pronostique
Limites du sujet:
Humains
Pays comme sujet:
Europe
langue:
Anglais
Texte intégral:
Healthcare Informatics Research
Année:
2013
Type:
Article
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