Episode Transcript
Announcer: 这些是发生在医疗保健内部的对话，它们将改变医疗保健. The health care insider is on The Scope.
Wendy: 我叫温迪·查普曼，是犹他大学生物医学信息学系主任, and we have a guest here, Dr. Ross Koppel. 科佩尔博士将在大发娱乐的系列研讨会上给大发娱乐做一个演讲，主题是如何建立一个更好的学习型卫生系统，大发娱乐的重点是如何从大发娱乐收集的数据的行动中学习, 这样大发娱乐就能改善医疗服务和社区的健康. Dr. Koppel is faculty at the University of Pennsylvania. He's in the Department of Sociology. 他是沃顿商学院伦纳德·戴维斯研究所的医学副教授和高级研究员. 他领导了许多与健康信息技术或健康信息技术有关的项目.
他是一位非常著名的卫生保健信息学家，他在这个领域发表了数百篇文章，领导了数十个项目, so it's a pleasure to have him here today. We'd like to your thoughts, Dr. Koppel, on the electronic medical records system which, right now, 在美国，电子医疗记录系统的使用率正在上升. With that, comes many opportunities to help collect data, 分享数据，从数据中学习，我想知道你认为这如何改变了医学实践，并大发娱乐大发娱乐成为一个学习型机构.
Dr. Koppel: Well, thank you. It's a pleasure to be here, Wendy. HIT，即医疗保健信息技术，是学习型医疗保健系统的基石. 它包含了大发娱乐想从病人那里得到的所有信息以及他们的治疗和药物, hopefully, their history and all of that. Without the EHR, electronic health record, as the basis, 大发娱乐真的不可能有一个学习型的卫生系统，因为大发娱乐需要所有的信息来了解大发娱乐做的是对的, what are doing wrong, about the ideology of disease, about what methods seem to be efficacious, 什么似乎会产生不必要的副作用之类的.
That said, 电子健康记录也存在同样的问题，影响大发娱乐使用它们来学习医疗保健系统的能力. So, for instance, the fact that we didn't focus on interoperability, 关于从其他医疗保健系统读取数据和接受数据的能力, or even from across the hallway, 意味着医生无法获得病人问题的完整记录, or the group, 当病人在某一特定医院时对其进行治疗. We don't know what the other medications are. 大发娱乐不知道以前做了什么，因为大发娱乐没有从一开始就关注数据标准, on data format standards, 加强跨卫生保健系统共享信息的能力, or even, as I said, sometimes, across the hallway.
It's a, sort of, Tower of Babel, or really a city of Towers of Babel, that comprise the healthcare systems' IT. And from that, 大发娱乐对病人身上发生的很多事情视而不见, since patients see more than one doctor, more than one physician group, more than one hospitalization. And of course, 美国在这方面面临的挑战尤其大，因为大发娱乐是唯一拥有医疗保健系统的国家, the only nation, really, 没有唯一的病人ID，没有唯一的病人ID，大发娱乐真的不知道谁坐在大发娱乐面前.
我自己的医疗保健系统是卓越和一流的, University of Pennsylvania, we counted 35 ways of recording a patient's name. So, there's "Koppel, R.", "Koppel, Ross", "Ross Koppel", "Ross J. Koppel", "Koppel, R.J.等等，然后，还有空格之类的. So, the lack of ability to combine data, just the data itself, assuming we knew the patient, 是由于无法知道大发娱乐在他们之前看的是哪个病人而加剧的.
大发娱乐现在可以在电子病历中挖掘海量的数据，而不是对30个服用某种药物且有病史的人进行研究, we could have the, more or less, 3.1亿美国人一起挖掘这些数据. But we can't, because the data is not shared across. I would venture to say, 大发娱乐可以将医学研究的进展加快10%, 20, or even 30 years, 如果大发娱乐能挖掘出包含所有信息的数据, about all of the patients, all of their treatments and all of their drugs, but we can't because they are in separate silos, in separate Towers of Babel.
Interviewer: What should we be doing about this?
Dr. Koppel: 我认为，大发娱乐必须要求负责监管的人不要太关注有多少地方实施了HIT, but rather on the quality the HIT, on the usability and usefulness, a word we haven't touched yet, usefulness of the HIT, 以及它与临床医生所参与的工作流程的配合程度. 没有理由说这个软件不能适应对病人安全和临床医生效率有意义的东西.
The other thing we should do, 大发娱乐是否应该有明确的测试标准和有意义的认证过程. 目前，认证过程有点可怜. You know, 当这些系统问世的时候，我曾经开玩笑说，每一个有妹夫知道VisiCalc并且拥有车库的医生都可以建立一个电子病历. The market is still open for all, 还有一些遗留系统不是很好用, often. 有时它们是很棒的，但它们被一个人使用. They talk to nobody. They go nowhere. 你一开始谈到的学习型医疗保健系统完全被这些系统所阻碍.
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