宫癌临床决策支持工具的使用:混合方法研究
Nathalie Huguet1, David Ezekiel-Herrera1, Rose Gunn2
1Department of Family Medicine, Oregon Health and Science University, Portland, Oregon, United States.
Applied clinical informatics
|August 2, 2023
概括
电子健康记录 (EHR) 临床决策支持 (CDS) 工具用于宫癌查的低采用率阻碍了改善护理. 有效的沟通和培训对于EHR工具在初级保健中被采用至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 妇科瘤学 妇科瘤学
背景情况:
- 集成到电子健康记录 (EHR) 中的临床决策支持 (CDS) 工具可以增强符合指南的宫癌查.
- 然而,在初级保健机构采用这些基于电子健康记录的工具往往是不理想的.
- 本研究研究了影响采用特定的宫癌查CDS工具 (CC-工具) 的因素.
研究的目的:
- 确定社区卫生中心采用CC工具的频率.
- 为了确定与CC工具使用相关的因素.
- 探索基于EHR的子宫癌查工具的采用障碍和促进者的障碍.
主要方法:
- 在18个州的480家诊所进行了一项混合方法的顺序解释性研究.
- 根据使用实例和2018年11月至2020年12月的月率来衡量CC工具的采用情况.
- 通过以用户为中心的设计会议和与诊所工作人员的半结构面试,收集了定性数据.
主要成果:
- 在41%的参与诊所中,CC工具至少被使用过一次.
- 使用CC工具较多的诊所有更多的患者接触和更高的最新宫癌查率.
- 关键的障碍包括缺乏意识,对功能缺乏理解,以及关于CC工具的培训不足.
结论:
- 基于EHR的工具如CC工具的广泛采用在没有强大的系统来通知用户新功能的情况下是有限的.
- 有效的沟通和培训策略至关重要,以最大限度地发挥CDS工具在改善医疗保健质量和患者成果方面的潜力.
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