临床决策的信息学支持

L. Ohno-Machado
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引用次数: 0

摘要

临床决策支持(CDS)系统的使用随着电子健康记录(EHR)系统在美国的实施而增加。第一个也是研究最多的CDS应用之一是计算机化提供者订单输入(CPOE),特别是与药物相关的CPOE。许多EHR系统在临床医生输入医嘱时检查药物剂量、过敏和药物-药物相互作用,并根据需要发出警报。然而,在CPOE系统中,警报重写是常见的做法。Nanji等人(见第487页)报告说,在一个特定的学术医疗中心,超过50%的警报被覆盖,并提出了如何减少意外的CPOE对工作流和通信的影响(见第481页)。关于工作流程,Coiera(见第414页)提供了一个模型来研究临床医生之间发生关键沟通的工作空间。这期的许多文章都集中在药物管理上,包括三个系统的评论,解决障碍和促进因素……
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Informatics support for clinical decisions
The utilization of Clinical Decision Support (CDS) systems is increasing with implementation of Electronic Health Record (EHR) systems across the USA. One of the first and most studied CDS applications has been computerized provider order entry (CPOE), particularly CPOE related to medications. Many EHR systems check drug dosage, allergies, and drug-drug interactions as clinicians enter their orders, and issue alerts as needed. However, alert overriding in CPOE systems is common practice. Nanji et al ( see page 487 ) reports that over 50% of alerts are overridden at a particular academic health center and proposes how to decrease unintended CPOE effects on workflows and communications ( see page 481 ). Related to workflows, Coiera ( see page 414 ) offers a model to study workspaces in which critical communications among clinicians occur. Many articles in this issue focus on medication management, including three systematic reviews that address barriers and facilitators …
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