临床决策支持系统在紧急电话分拣:技术设计,实施和评估的范围审查
Julie Michel1, Aurélia Manns2, Sofia Boudersa3
1SAMU 93-UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny, France.
International journal of medical informatics
|January 30, 2024
概括
临床决策支持系统 (CDSS) 可以改善紧急电话分拣. 这次审查发现了文献上的差距,强调了需要混合,用户定制和EHR连接的系统,以更好地管理患者并减少过度拥挤.
科学领域:
- 医疗信息学 医疗信息学
- 紧急医疗 紧急医疗
- 临床决策支持 临床决策支持
背景情况:
- 紧急部门过度拥挤是一个重大挑战.
- 上游电话分类可以通过早期管理患者来缓解过度拥挤.
- 临床决策支持系统 (CDSS) 为紧急电话分拣提供了潜在的改进.
研究的目的:
- 进行CDSS用于紧急电话分拣的范围审查.
- 在这些系统的开发和评估中识别文献上的差距.
- 在这个领域为未来的研究和开发提供信息.
主要方法:
- 根据PRISMA-ScR指南进行范围审查.
- 基于功能特征,技术设计,实施和评估方法的CDSS分析.
- 基于知识和数据驱动的CDSS的比较.
主要成果:
- 确定了19个CDSS,12个是基于知识的,7个是数据驱动的.
- 大多数CDSS协助护士进行患者指导和优先评估.
- 在实践中实施了11个CDSS,但只有3个与电子健康记录 (EHR) 集成.
- 评估方法各不相同,实用性和随机对照试验有限.
结论:
- 未来的CDSS应该是混合,用户定制,灵活和EHR连接的,支持各种数据输入 (口头,视频,数字).
- 对CDSS的代评估至关重要,重点关注整个IT生命周期的内在特征和临床实践影响.
- 解决已识别的文献缺口将提高CDSS在紧急电话分拣中的有效性.
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