[翻译]医生抵制电子医嘱系统

eConnect - August 2004

Physician resistance to e-prescribing persists
医生抵制电子医嘱系统

Author: Bernie Monegain, News/online editor
eConnect Code: eprescribe 0804

Physician resistance continues to be a key barrier to widespread adoption of electronic prescribing, an informal poll taken by Healthcare IT News reveals.

Healthcare IT News组织了一个非正式的投票，结果表明医生的抵制态度依旧是推广电子医嘱系统的一个关键的障碍。

“The term, “electronic prescribing” or “e-prescribing,” has lots of meanings to physicians in private practice, and many of them are negative,” said Michael Lake, an independent consultant. based in San Francisco. “That’s because the term was used extensively several years ago, when it meant giving away hand-held computers with the focus completely placed on attempting to replace the prescription pad.”

“electronic prescribing或者叫e-prescribing，对于私人医师意味着很多，并且其中许多人都是持否定态度的。” Michael Lake，这位居于洛杉矶的中立的顾问说，“那是因为在这个术语被广泛使用的这些年里，焦点一直集中在手持的电脑尝试完全替代医嘱本这件事上。”

Times have changed, Lake said, equipment is improved and much better integrated to office workflow, but the story is not being effectively told.

Lake说，时代在变化，设备被改良，工作流程越来越完善，但是这些事情并没有被很好的宣传。

Lake suggests an education campaign would go a long way toward boosting adoption of e-prescription.

Lake建议，为了推进电子医嘱的采用，我们需要开展一段很长过程的培训。

“Physician resistance is still a factor,” agreed Tom Goodwin, Information Systems, MIT Medical Department. “Physicians need to be able to write a script from the exam room while they are with the patient. This is possible now but more resource commitment is needed to further adaptation. Regulators and insurers need to but more pressure on the medical community to make this happen,” he said.

“医生的抵制依旧是一个因素”，MIT医学部门信息系统的Tom Goodwin表示赞同，他说，“在医生们和病人在一起的时候，他们需要能够纪录手稿。这件事现在也许可以做到，但是更多的相关环节需要进一步的相适应。管理人和确认人是必须的，但是这些事情使医学团体承载了更大的压力。

Tony Sara, associate director of clinical information systems at South Eastern Sydney Area Health Service in Australia, offers two main barriers to implementation: lack of products that properly interface and lack of funds.

Tony Sara，澳大利亚South Eastern Sydney Area Health Service的临床信息系统的副主管提出了在具体实施的过程中两个主要的障碍：缺少拥有完整软件接口的产品，缺少资金。

“The vendors tell us one thing,” Sara said, “but the reality is quite different, particularly when interfacing from prescribing to pharmacy to med admin record systems.”

“销售方只跟我们谈一个方面的事情”，Sara说，“但实际情况是不一样的，很明显的，比如从下医嘱到药房配药再到药库记录这个流程的软件接口问题。

Sean O’Rourke, Information Services at the University of Pittsburgh Medical Center finds several barriers as he tries to work with payers on e-prescribing.

匹兹堡大学医学中心的信息服务部门的Sean O’Rourke，在尝试通过电子医嘱收费的工作中发现了很多的障碍。

Here are two he mentioned.

下面是他提到的其中的两个：

- Payer and provider data (e.g., formulary information) are at different levels of detail, making use of payer formulary information at the time of prescribing difficult (the lack of which leads to consumer and patient dissatisfaction).

- 交费数据和收费数据（比如：医嘱信息）的细化程度不同，利用下医嘱时的医嘱缴费信息是困难的（缺陷是招致消费者，患者的不满）。

- Current standards for medications are generally at the description level, there are no transaction level standards.

- 目前药物的规格还是靠描述和形容，没有事务流通级别上的标准。

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