Informatics systems to promote improved care for chronic illness: A literature review

被引:154
作者
Dorr, David
Bonner, Laura M.
Cohen, Amy N.
Shoai, Rebecca S.
Perrin, Ruth
Chaney, Edmund
Young, Alexander S.
机构
[1] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR USA
[2] VA Puget Sound Healthcare Syst, NW HSR&D Ctr Excellence, Seattle, WA USA
[3] VA Desert Pacific Mental Illness Res Educ & Clin, Los Angeles, CA USA
[4] VA Informat Resource Ctr, Hines, IL USA
[5] Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA
关键词
D O I
10.1197/jamia.M2255
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
Objective: To understand information systems components important in supporting team-based care of chronic illness through a literature search. Design: Systematic search of literature from 1996-2005 for evaluations of information systems used in the care of chronic illness. Measurements: The relationship of design, quality, information systems components, setting, and other factors with process, quality outcomes, and health care costs was evaluated. Results: In all, 109 articles were reviewed involving 112 information system descriptions. Chronic diseases targeted included diabetes (42.9% of reviewed articles), heart disease (36.6%), and mental illness (23.2%), among others. System users were primarily physicians, nurses, and patients. Sixty-seven percent of reviewed experiments had positive outcomes; 94% of uncontrolled, observational studies claimed positive results. Components closely correlated with positive experimental results were connection to an electronic medical record, computerized prompts, population management (including reports and feedback), specialized decision support, electronic scheduling, and personal health records. Barriers identified included costs, data privacy and security concerns, and failure to consider workflow. Conclusion: The majority of published studies revealed a positive impact of specific health information technology components on chronic illness care. Implications for future research and system designs are discussed.
引用
收藏
页码:156 / 163
页数:8
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