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[ACC2011]心房颤动的药物治疗—— Joseph S. Alpert教授专访

作者:  JosephS.Alpert   日期:2011/3/29 16:07:18

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《国际循环》:在老年人中多种药物合用有多常见?这有问题吗?

    <International Circulation>:  Doesn’t that beg the question: Isn’t there a central database keeping track of these patients so these things never happen?

  《国际循环》:这是否提出了这样一个问题:是否有一个中心数据库与这些患者保持联系以确保这些情况永远不会发生?

    prof Alpert:The simple answer is no. In fact that is exactly what we want. What would be wonderful would be if whenever I saw a doctor there was a central computer repository that kept a record of that meeting. The proof that that would work is where you have integrated health care systems like the Mayo where every note and piece of lab data goes into the same electronic file and every doctor has access to that when they see the patient, of course, within the Mayo. We are just in the process of integrating our group practice in our hospital in the same way. When you see a patient, you will be able to see what has happened in the hospital, what the lab values were, what the primary care doctor said, what the surgeon said and so on. I would love to see that as standard to a national level because patients travel and doctors travel. We communicate but sometimes the communication isn’t perfect backwards and forwards. If every patient had a central electronic repository and only accessed appropriately for security purposes, it would be wonderful. That is what the military does. When you are in the military, you carry your medical record. If you get transferred from post A to post B, they won’t let you on the post until you bring your medical record and it has everything about you in there. It is not electronic but it proves how excellent the concept is that there is a comprehensive and complete medical record accessible to everyone who takes care of you. 

    Alpert教授:简单来讲,没有。但实际上这正是我们所想要的。如果无论何时我去看医生,都有一台能够保存该访视记录的中央计算机,将是多棒的事情。这会起作用的证据是,在有综合医疗保健系统的地方,譬如梅奥医学中心,每个记录和实验室数据样本都会录入相同的电子文件,且每个医生在他们诊室患者时都可以访问该文件,当然,仅限于梅奥医学中心内部。我们医院正在以相同方式整合团体实践的过程中。当看到一例患者时,你将能够看到在该医院中发生过什么,实验室检查的结果,主治医生的说法,外科医生的说法等等。我很想看到以此为标准在全国水平推广,因为患者和医生都会迁移。我们进行沟通,但有时来回沟通并不理想。如果每例患者都有一个中央电子数据库,且仅允许为安全性目的进行适当访问,那将会是极好的。这是军队的做法。在军队中时,你要携带你的医疗记录。如果你从A职位转到B职位,除非你将包含你所有情况的医疗记录带来,否则他们不会让你入职。虽然这种记录不是电子的,但它证明了有一个能让照顾你的每个人都可以访问的综合、完整的医疗记录这一概念是何等优秀。

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