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开发临床决策支持工具,在儿科初级保健中实施喘管理指南:定性研究
David A Fedele1, Jessica M Ray2, Jaya L Mallela3
1Center for Healthcare Delivery Science, Nemours Children's Health, Jacksonville, FL, United States.
JMIR formative research
|March 18, 2025
概括
初级保健提供者需要高效的电子健康记录 (EHR) 工具来遵循喘指南. 临床决策支持 (CDS) 工具的以用户为中心的设计可以改善初级保健机构的喘护理.
科学领域:
- 医疗信息学 医疗信息学
- 初级医疗保健医学 一级医疗保健医学
- 临床决策支持系统 临床决策支持系统
背景情况:
- 国家喘指南与其初级保健实施之间存在很大的差距.
- 初级保健提供者 (PCP) 面临与提供者和实践相关的障碍,以遵守指南.
- 需要有效的工具来支持基于指南的喘护理在护理点.
研究的目的:
- 应用以用户为中心的设计原则来开发嵌入EHR的临床决策支持工具 (CDS).
- 从PCP和IT专业人员收集关于喘管理指南的形成性定性数据.
- 为设计CDS工具提供信息,使其与最近的喘指南更新保持一致.
主要方法:
- 定性研究采用15名PCP和医疗保健IT专业人员的有目的抽样.
- 与PCP的采访重点是喘诊断,指南熟悉性和CDS工具集成.
- 与IT专业人员的采访探讨了CDS工具设计和EHR实施过程.
- 录音和转录的定性数据的感应主题分析.
主要成果:
- PCP的主题包括喘评估实践,指南实施经验和CDS工具的工作流集成.
- 医疗保健IT专业主题涵盖了CDS工具设计流程和基于价值的证据收集.
- 两个小组都强调了需要高效且适合现有工作流程的工具.
结论:
- 以用户为中心的设计指导了EHR集成喘CDS工具的开发.
- PCP希望低负担,高效的CDS工具来加强对喘指南的遵守.
- 医疗保健IT专业人员强调了遵守CDS工具实用性的EHR设计标准的重要性.
- 实施这些CDS工具可以通过改善指导方针的遵守来潜在地减少儿科喘发病率.
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