TY - JOUR AU - Hackett, Christina AU - Brennan, Kelsey AU - Smith Fowler, Heather AU - Leaver, Chad PY - 2019 DA - 2019/06/06 TI -重视公民获得数字医疗服务的机会:在加拿大环境下应用基于价值的结果和现代化卫生系统的工具JO - J Med Internet Res SP - e12277 VL - 21 IS - 6kw -个人健康记录KW -患者门户KW -电子健康记录KW -患者参与KW -医疗成本KW -疾病成本KW -经济评估AB -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质量和安全性并改善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。方法:我们首先综合了加拿大和国际上对患者和服务提供者与PHRs相关的结果的各种研究结果，这些研究涉及一系列服务，从在网上查看信息(如实验室结果)到电子处方更新，再到与护理团队和提供者的电子邮件或视频会议。然后，我们根据这些已证明的利益和公民使用(2016-2017)开发了一个估计价值的定量模型。除了从患者和系统的角度估计节省的成本外，我们还使用了补偿差异方法的新应用来评估使用PHR所带来的改善健康和福祉的社会价值(独立于成本)。结果:患者使用一系列数字PHR功能，通过提高卫生系统生产力，改善卫生保健的可及性和质量，为加拿大人和卫生系统创造了价值。 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. SN - 1438-8871 UR - //www.mybigtv.com/2019/6/e12277/ UR - https://doi.org/10.2196/12277 UR - http://www.ncbi.nlm.nih.gov/pubmed/31172965 DO - 10.2196/12277 ID - info:doi/10.2196/12277 ER -