信息技术支持下慢性病患者共享护理的有效性研究卡塔尔世界杯8强波胆分析A系统综述%A Kooij,Laura %A Groen,Wim G %A van Harten,Wim H %+荷兰癌症研究所，心理社会研究与流行病学部，Plesmanlaan 121，阿姆斯特丹，1066CX，荷兰，31 88 005 75,w.v.harten@nki.nl %K综述%K综合医疗保健系统%K健康信息系统%K慢性疾病%D 2017 %7 22.06.2017 %9原始论文%J J Med Internet Res %G英文%X背景:在慢性疾病患者中，许多卫生保健专业人员在治疗和随访期间参与。这导致碎片化，进而可能导致次优护理。共享护理是一种改善由各种提供者，特别是初级保健医生(pcp)和专科护理专业人员为慢性病患者提供的护理整合的手段。信息技术(IT)在这一领域的应用似乎大有前途。目的:我们的目的是系统地回顾有关信息技术支持的慢性病共享护理干预在提供者或专业、过程、健康或临床和财务结果方面的有效性的文献。此外，我们的目标是提供支持此类干预的IT应用程序特征的清单。方法:检索PubMed、Scopus和EMBASE从2006年到2015年，使用与共享医疗、慢性病和IT相关的搜索词识别相关研究。符合条件的研究是用英语进行的，随机对照试验(rct)、对照试验或单组前后研究报告了信息技术支持的共享护理对慢性疾病和癌症患者的影响。 The interventions had to involve providers from both primary and specialty health care. Intervention and IT characteristics and effectiveness—in terms of provider or professional (proximal), process (intermediate), health or clinical and financial (distal) outcomes—were extracted. Risk of bias of (cluster) RCTs was assessed using the Cochrane tool. Results: The initial search yielded 4167 results. Thirteen publications were used, including 11 (cluster) RCTs, a controlled trial, and a pre-post feasibility study. Four main categories of IT applications were identified: (1) electronic decision support tools, (2) electronic platform with a call-center, (3) electronic health records, and (4) electronic communication applications. Positive effects were found for decision support-based interventions on financial and health outcomes, such as physical activity. Electronic health record use improved PCP visits and reduced rehospitalization. Electronic platform use resulted in fewer readmissions and better clinical outcomes—for example, in terms of body mass index (BMI) and dyspnea. The use of electronic communication applications using text-based information transfer between professionals had a positive effect on the number of PCPs contacting hospitals, PCPs’ satisfaction, and confidence. Conclusions: IT-supported shared care can improve proximal outcomes, such as confidence and satisfaction of PCPs, especially in using electronic communication applications. Positive effects on intermediate and distal outcomes were also reported but were mixed. Surprisingly, few studies were found that substantiated these anticipated benefits. Studies showed a large heterogeneity in the included populations, outcome measures, and IT applications used. Therefore, a firm conclusion cannot be drawn. As IT applications are developed and implemented rapidly, evidence is needed to test the specific added value of IT in shared care interventions. This is expected to require innovative research methods. %M 28642218 %R 10.2196/jmir.7405 %U //www.mybigtv.com/2017/6/e221/ %U https://doi.org/10.2196/jmir.7405 %U http://www.ncbi.nlm.nih.gov/pubmed/28642218