@文章{信息:doi/10.2196/12277，作者=“Hackett, Christina and Brennan, Kelsey and Smith Fowler, Heather and Leaver, Chad”，标题=“重视公民获得数字医疗服务:在加拿大背景下应用基于价值的结果和现代化卫生系统的工具”，期刊=“J Med Internet Res”，年=“2019”，月=“6”，日=“06”，卷=“21”，数=“6”，页=“e12277”，关键词=“个人健康记录;病人门户;电子健康记录;病人参与;保健费用;疾病费用;背景:在公共资助的卫生系统中，数字卫生技术是旨在提高卫生保健服务的质量和安全性并增强患者体验和结果的战略。在加拿大，政府和卫生组织已经投资于数字卫生技术，如个人健康记录(PHRs)和其他电子服务功能，以及跨省和地区卫生系统的创新。目的:患者通过安全的、基于web的phrr和集成的虚拟护理服务访问自己的信息是支持患者参与卫生保健的有希望的机制。我们利用现有证据开发了一个经济模型，以估计这些数字卫生倡议的已展示价值和潜在价值。 Methods: We first synthesized results from a variety of Canadian and international studies on the outcomes for patients and service providers associated with PHRs across a continuum of services, ranging from viewing information (eg, laboratory results) on the Web to electronic prescription renewal to email or video conferencing with care teams and providers. We then developed a quantitative model of estimated value, grounded in these demonstrated benefits and citizen use (2016-2017). In addition to estimating the costs saved from patient and system perspectives, we used a novel application of a compensating differential approach to assess the value (independent of costs) to society of improved health and well-being resulting from PHR use. Results: Patients' access to a range of digital PHR functions generated value for Canadians and health systems by increasing health system productivity, and improving access to and quality of health care provided. As opportunities increased to interact and engage with health care providers via PHR functions, the marginal value generated by utilization of PHR functionalities also increased. Web-based prescription renewal generated the largest share of the total current value from the patient perspective. From the health systems perspective, Canadians' ability to view their information on the Web was the largest value share. If PHRs were to be implemented with more integrated virtual care services, the value generated from populations with chronic illnesses such as severe and persistent mental illness and diabetes could amount to between Can {\$}800 million and Can {\$}1 billion per year across Canadian health systems. Conclusions: PHRs with higher interactivity could yield substantial potential value from wider implementation in Canada and increased adoption rates in certain target groups---namely, high-frequency health system users and their caregivers. Further research is needed to tie PHR use to health outcomes across PHR functions, care settings, and patient populations. ", issn="1438-8871", doi="10.2196/12277", url="//www.mybigtv.com/2019/6/e12277/", url="https://doi.org/10.2196/12277", url="http://www.ncbi.nlm.nih.gov/pubmed/31172965" }