作业_信息系统与组织变化

作业_信息系统与组织变化 背景知识——电子医疗纪录的基本概念（摘自wiki） An electronic medical record (EMR) is a computerized medical record created in an organization that delivers care, such as a hospital or physician's office. Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and modification of records. Comparison with paper-based records Paper-based records are still by far the most common method of recording patient information for most hospitals and practices in the U.S. The majority of doctors still find their ease of data entry and low cost hard to part with. However, as easy as they are for the doctor to record medical data at the point of care, they require a significant amount of storage space compared to digital records. In the US, most states require physical records be held for a minimum of seven years. The costs of storage media, such as paper and film, per unit of information differ dramatically from that of electronic storage media. When paper records are stored in different locations, collating them to a single location for review by a health care provider is time consuming and complicated, whereas the process can be simplified with electronic records . This is particularly true in the case of person-centered records, which are impractical to maintain if not electronic (thus difficult to centralise or federate). When paper-based records are required in multiple locations, copying, faxing, and transporting costs are significant compared to duplication and transfer of digital records. Because of these many "after entry" benefits, federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic medical records. Handwritten paper medical records can be associated with poor legibility, which can contribute to medical errors. Pre-printed forms, the standardization of abbreviations, and standards for penmanship were encouraged to improve reliability of paper medical records. Electronic records help with the standardization of forms, terminology and abbreviations, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. EMRs in the United States Usage Even though EMR systems with a computerized provider order entry (CPOE) have existed for more than 30 years, fewer than 10 percent of hospitals as of 2006 had a fully integrated system. In the United States, the CDC reported that the EMR adoption rate had steadily risen to 48.3 percent at the end of 2009. This is an increase over 2008, when only 38.4% of office-based physicians reported using fully or partially electronic medical record systems (EMR) in 2008. However, the same study found that only 20.4% of all physicians reported using a system described as minimally functional and including the following features: orders for prescriptions, orders for tests, viewing laboratory or imaging results, and clinical notes. Technical features Using an EMR to read and write a patient's record is not only possible through a workstation but depending on the type of system and health care settings may also be possible through mobile devices that are handwriting capable. Electronic Medical Records may include access to Personal Health Records (PHR) which makes individual notes from an EMR readily visible and accessible for consumers. Event monitoring Some EMR systems automatically monitor clinical events, by analyzing patient data from an electronic health record to predict, detect and potentially prevent adverse events. This can include discharge/transfer orders, pharmacy orders, radiology results, laboratory results and any other data from ancillary services or provider notes. 1． 请阅读资料‘信息系统案例’中的三个案例。 2． 从已学过的相关理论知识角度，分别每个案例，参照以下问题写出分析结果： a) 信息系统项目实施前的组织特点是什么？ b) 抵制行为的主体是谁？ c) 主体感受到了什么威胁？ d) 信息系统项目中什么成为被抵制对象是什么？ e) 抵制行为的演变过程是怎样的？ 3． 你认为信息系统项目实施的性质是什么？ 4． 写分析，使用A4纸张。 �The advantages of the digital records compared with the paper records. �Application fields. �Disadvantages of the paper records and to strength the benefits of the electronic records