数字化医疗信息安全管理机制研究

目前,我国在医疗信息安全保障建设方面严重滞后,信息安全工作的战略统筹和综合协调不够,缺乏体系化的安全策略研究以及针对数字化医疗业务特点的管理机制研究。为了实现安全可信的医疗信息发展环境,笔者针对现有医疗信息系统中各个需要实施安全保护的目标,给出了在推动医疗信息安全保障体系建设方面应涉及的各项安全问题及管理机制,旨在构建一个全面涵盖了信息技术、组织策略、法律意识的整体性治理方案。     

Electronic medical record use and efficiency: A DEA and windows analysis of hospitals

We use data envelopment analysis (DEA) to examine the relationship between hospital electronic medical record (EMR) use and efficiency in a national sample of acute care hospitals. Data sources include the American Hospital Association (AHA), Health Information Management Systems Society (HIMSS), and Case Mix Index. Using two research approaches including a retrospective, cross-sectional design and a first differencing repeated measures design, we find limited evidence that EMRs can improve hospital efficiency. Small hospitals may benefit in the area of efficiency through EMR use, but medium and large hospitals generally do not demonstrate such a difference. Likewise, there does not appear to be a significant increase in efficiency over time associated with EMRs when compared to the efficiency of hospitals without such documentation.     

The Medicare Electronic Health Records (EHR) Incentive Program: First-Year Adoption Response from Inpatient Hospitals

This study investigates electronic health records (EHR) adoption among inpatient hospitals in response to the first operational year of the Medicare EHR Incentive Program. Profile analysis of public attestation datasets finds both system adoption rates and implemented functionalities to have been significantly influenced by the incentive program’s attributes. Key dates and periods in the program’s well-publicized timeline were usually accompanied by spikes in the number of attested systems and/or dips in advanced functionalities. The implication is that hospitals have responded to the program by swiftly implementing EHR systems with capabilities just sufficient to meet program requirements, in order to be able to promptly file attestations and thus claim their incentive payments. The program therefore appears to have yielded mixed results. While it seems to have induced more hospitals to acquire EHR systems, the implemented systems generally possess minimal functionalities, suggesting that adopters have leveraged the program’s rules in order to maximize their own short-term gains.