关于CDS故障的专题号:在两个商业EHR系统中使用当前决策支持基础设施来降低警报负担的挑战:经验教训和前进道路
Tiago K Colicchio1, David El Halta2, Guilherme Del Fiol3
1Department of Biomedical Informatics and Data Science, University of Alabama at Birmingham, Birmingham, United States.
Applied clinical informatics
|February 28, 2025
概括
在电子健康记录 (EHR) 系统中整合一种抑制虚假阳性临床决策支持 (CDS) 警报的方法遇到了重大障碍. 克服这些需要更灵活的CDS基础设施和利益相关者的合作.
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
- 电子健康记录电子健康记录
背景情况:
- 过度的临床决策支持 (CDS) 警报经常被临床医生忽视.
- 开发了一种基于先前药物耐受性的新方法来抑制虚假阳性警报.
- 集成到商业电子健康记录 (EHR) 系统中遇到了重大障碍.
研究的目的:
- 描述将定制的CDS报警抑制方法集成到两个商业EHR系统中的挑战.
- 为未来的CDS研究和设计提供建议.
- 解决EHR系统中临床上无关紧要的警报问题.
主要方法:
- 调查新的CDS标准 (例如CDS Hooks) 进行可扩展的警报增强.
- 试图定制商业药物知识库 (MKBs),以减少假阳性警报.
- 探索了先前耐药患者过敏文档的手动失活.
主要成果:
- 基于标准的方法 (CDS Hooks) 不适合抑制现有的供应商提供的药物过敏警报 (DAA).
- 商业EHR系统缺乏对压制MKB导入警报所需的离散临床文档更改的支持.
- 手动禁用过敏文档是不切实际的,因为需要单独的成分级规则.
结论:
- 显著的障碍妨碍了实施一种新的方法来抑制在商业电子健康记录中临床上无关紧要的CDS警报.
- 一个更灵活的CDS基础设施是成功集成所必需的.
- 多种利益相关者之间的合作对于推进CDS设计和实施至关重要.
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