美国医疗信息电子化10年计划出台

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美国医疗信息电子化10年计划出台
2004-07-26 14:15:07 　　
  
　　美国政府7月21日 推出了一项“医疗信息电子化”10年计划。根据该计划，在美国以笔墨书写纸病历和处方的方法将成为历史，电子病历和处方时代即将来临。据联邦政府21日发表的报告称，政府将和私人机构合作确立技术标准，使医生、医院、实验室、药店和保险公司的计算机系统可以相互连接、分享信息。联邦政府也将以“联邦医疗保险”计划和“医疗补助”计划为后盾，借助强大的采购能力，加速医疗体系向电子病历的转化进程。  

　　美国卫生与公众服务部部长汤普森说：“政府将扮演绝对重要的角色。但由于医疗单位的分散，政府必须鼓励标准化，以降低医疗信息技术投资的风险。”“医疗信息电子化”计划呼吁，政府与私人企业应合作发展储存电子医疗纪录的标准，以供医疗企业分享，并要考虑个人信息资料的安全性。此外，也要考虑开发一套产品认证系统。建议组成一个由政府和私人公司参与的集团，以规划、建立和管理医疗信息网络。同时，一个由企业主管、医疗专家组成的“卫生信息技术领导小组”(HITLP)负责向政府提供有关医疗信息技术成本与效益的咨询信息。该计划其他内容还包括政府建立一个网站，以供医疗受益人了解他们所能获得的服务内容。  

　　政府和保健专家说，医疗信息电子化可大大节省医疗成本，并挽救很多生命。据估计，病历电子化后，美国每年可节省1400亿美元，相当于节约近10%的全美医疗支出。除了减少使用纸张外，电子系统自动化还可大幅度降低医疗过错，从而避免每年因医疗过错而造成的4.5万到9.8万人的死亡，这一死亡数字超过由乳腺癌、艾滋病或摩托车意外事故造成的死亡人数。  

　　同大多数产业相比，年产值1.5万亿美元的美国医疗业并未大量投资信息技术。例如，医疗行业年人均信息技术投资为3000美元，而平均私人企业投资额为7000美元，银行业为15000美元。  

  
科技日报

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Legal Issues May Block Digital Health Records -- GAO



WASHINGTON (Reuters) Aug 17 - Uncertainty surrounding a host of legal issues may stall adoption of electronic medical records and U.S. officials have done little to address the problem, a congressional watchdog agency said Monday.

The Bush administration has trumpeted its efforts to push hospitals into the computer age, thereby cutting paperwork costs and reducing medical errors. On the campaign trail, President George W. Bush has touted a goal of storing most Americans' medical records in electronic form within 10 years.

Most of the $228 million spent by the Department of Health and Human Services in the current fiscal year in this area has gone to testing of electronic systems and coordinating information among federal agencies and private entities, according to the Government Accountability Office.

"Various laws present barriers to adoption of health (information technology), and at the time of our review HHS's efforts to address these barriers had been limited in scope," the GAO said in a letter to New Hampshire Republican Sen. Judd Gregg, who requested the review.

The laws that may interfere go beyond those protecting privacy and information security, the GAO said.

For example, doctors may hesitate to accept information technology services from hospitals for fear they may be viewed as payment for patient referrals and thus violate anti-kickback laws, the GAO said.

"To the extent there are uncertainties and ambiguity in predicting legal consequences, health-care providers are reluctant to take action and make significant investments" in electronic technology, the GAO said.

HHS, in a written response, took issue with some of the GAO's conclusions that various laws would discourage movement toward electronic records.

It said The GAO analysis also failed to address HHS efforts to establish privacy and security standards.

But the agency said it was concerned hospitals may provide free or discounted technology to physicians in an effort to influence referral decisions. Any exceptions to the laws "would need to be crafted carefully to exclude abusive arrangements," HHS said.

The agency also noted that it has no legal jurisdiction over many of the areas mentioned, such as antitrust and state licensing laws.

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