基于规则的临床决策支持故障的范围审查
Jeritt G Thayer1,2,3, Amy Franklin2, Jeffrey M Miller1
1Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA 19146, United States.
概括
对临床决策支持 (CDS) 功能障碍的研究是有限的,特别是对于像SMART和CDS Hooks这样的现代系统. 现有的分类学需要更新,以反映医疗IT和服务导向架构的进步.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持系统 临床决策支持系统
- 软件工程 软件工程 软件工程
背景情况:
- 临床决策支持 (CDS) 系统是现代医疗保健不可或缺的一部分.
- 了解CDS中的故障对于患者安全至关重要.
- 现有的关于CDS故障的研究并不全面,特别是在新架构方面.
研究的目的:
- 进行研究研究的范围审查,详细说明基于规则的临床决策支持 (CDS) 的故障.
- 识别和分类CDS故障和相关因素.
- 评估CDS故障对患者护理的影响.
主要方法:
- 在2022年4月的MEDLINE,CINAHL和Embase数据库中搜索了关于CDS故障的文献.
- 使用现有分类学编码识别的故障,并引入新的类别.
- 提取和总结了关于CDS系统架构,数据源和数据格式的信息.
主要成果:
- 在28篇文章中确定了130个故障.
- 在独立的,集成的和面向服务的架构 (例如,SMART,CDS Hooks) 中发生了故障.
- 没有发现基于标准的CDS故障;分类学更新了新的原因 (组织政策,硬件错误,数据源).
- 只有22%的故障报告了对患者护理的潜在影响.
结论:
- 关于CDS故障的研究有限,对SMART和CDS Hooks等现代架构的关注甚至更少.
- CDS故障发生在各种护理交付架构中.
- 为了应对医疗信息技术的进步,特别是面向服务的架构,需要不断更新CDS故障分类法.
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