利用电子健康记录数据为超重和肥胖儿童制定干预措施。

On-line journal of nursing informatics Pub Date : 2015-01-01 Epub Date: 2015-02-02
Jill Cochran, Adam Baus
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引用次数: 0

摘要

儿童肥胖症及其引发的并发症已成为西弗吉尼亚州乃至全美初级护理人员的沉重负担。建立具有文化敏感性的临床干预措施以满足人口健康需求是一项多因素挑战。从历史上看,准确评估门诊人群的人口统计特征一直很困难。幸运的是,电子健康记录(EHR)的使用为临床记录和常规收集基本人口统计和临床数据的能力带来了重大转变。虽然医疗保险和医疗补助服务中心(Centers for Medicare and Medicaid Services)规定的 "有意义使用"(Meaningful Use)数据越来越多地被用于评估临床护理和结果,但在 "有意义使用 "范围之外的电子病历数据的使用却没有得到足够的重视。本研究探讨了电子病历数据在 "有意义使用 "之外的使用情况,以获取农村初级保健中心肥胖和超重儿科人群的人口统计学特征,从而为适当的、与当地相关的干预策略提供信息。我们发现,每位患者所记录信息的广度和深度可共同提供宝贵的信息,用于描述和评估门诊人群,确定优先解决的领域,并衡量随时间推移而发生的变化。应用电子病历数据来了解这一特殊患者群体的人口统计学特征,凸显了确定目标患者群体、揭示关键的患者层面和群体层面结果、为干预措施的制定和实施提供信息,以及为质量改进系统转型工作增添价值的能力。在 "有意义使用 "范围之外使用电子健康记录数据,需要在初级保健中引起更多关注。
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Developing Interventions for Overweight and Obese Children using Electronic Health Records Data.

Childhood obesity and the resulting co-morbid conditions have become a massive burden for primary caregivers in West Virginia and across the United States. Building culturally sensitive clinical interventions to meet population health needs presents a multi-factorial challenge. Historically it has been is difficult to accurately assess the demographic characteristics of clinic populations. Fortunately, the use of electronic health records (EHR) has created a major shift in clinical documentation and ability to routinely collect essential demographic and clinical data. While data for Meaningful Use under the Centers for Medicare and Medicaid Services is increasingly used to evaluate clinical care and outcomes, use of EHR data outside of the Meaningful Use umbrella has not received sufficient attention. This study explores use of EHR data beyond Meaningful Use to obtain demographic characteristics of an obese and overweight pediatric population in a rural primary care center for the purpose of informing appropriate, locally relevant intervention strategies. We find that the breadth and depth of information recorded on each patient can collectively provide valuable information to describe and evaluate the clinic population, identify priority areas to address, and measure change over time. Application of EHR data to understand the demographic characteristics of this particular patient population highlights the ability to identify target patient populations, uncover critical patient-level and population-level outcomes, inform intervention development and implementation, and add value to efforts in quality improvement systems transformation. Use of EHR data outside of the Meaningful Use umbrella needs increased attention in primary care.

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