在电子健康记录中实施的共享决策工具:范围审查
Joni H Pierce1, Charlene Weir1, Teresa Taft1
1Department of Biomedical Informatics, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States.
Journal of medical Internet research
|February 21, 2025
概括
将共享决策 (SDM) 工具整合到电子健康记录 (EHR) 中,有望改善患者护理. 标准化和临床医生工作流程集成是成功在日常实践中采用SDM的关键.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 患者参与 患者参与
背景情况:
- 以患者为中心的护理强调患者参与医疗保健决策.
- 共享决策 (SDM) 的实施面临技术问题,时间限制和工作流集成挑战等障碍.
- 电子健康记录 (EHR) 为将SDM工具整合到临床实践中提供了一个平台.
研究的目的:
- 了解在EHR系统中的SDM干预措施的整合和实施特点.
- 确定影响SDM工具在现实临床环境中成功采用SDM工具的因素.
主要方法:
- 在Joanna Briggs研究所的指导下,使用Arksey和O'Malley框架进行了范围审查.
- 在多个数据库 (MEDLINE,Embase,CINAHL,Cochrane,PsycINFO,Scopus,Web of Science) 搜索了关于SDM和EHR整合的研究.
- 包括专注于真实世界的临床环境和电子健康记录集成的原始研究和评论;不包括回顾性研究,意见稿和社论.
主要成果:
- 18项研究 (0.84%) 符合资格标准,显示SDM定义,整合和实施的显著差异.
- 将SDM工具集成到电子健康记录中,在94%的研究中改善了结果.
- 大多数干预措施针对临床医生,患者的目标和价值观包括在56%的研究中.
结论:
- 将SDM工具集成到EHR临床医生的工作流程中,是日常实践的逻辑步骤.
- 标准化SDM工具和流程,包括患者决策辅助工具,对于一致性至关重要.
- 未来的研究应该专注于随机对照试验的电子健康记录整合和实施战略,强调患者的价值观.
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