临床医生对采用和实施EMR集成的临床决策支持工具在初级保健中的观点
Debora Goetz Goldberg1,2, Tulay G Soylu3, Carolyn Faith Hoffman1
1Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, USA.
初级保健临床医生认为临床决策支持 (CDS) 工具具有价值,但在实施时面临重大障碍. 成功的策略需要强有力的组织支持,明确的证据和无的EMR集成.
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:
- 临床决策支持 (CDS) 工具为患者护理提供了潜在的好处.
- 在初级保健机构中广泛采用面临实施挑战.
研究的目的:
- 了解初级保健临床医生对挑战,障碍和实施和传播CDS工具的策略的看法.
- 确定影响CDS成功融入初级保健工作流程的因素.
主要方法:
- 使用深入的,半结构化的访谈进行定性研究.
- 美国多个不同实践环境的32名初级保健临床医生参与了这项研究.
- 采访是在2021年7月至2023年9月期间进行的.
主要成果:
- 临床医生使用CDS工具的频率和类型不同;机器学习和预测分析工具不太常见.
- 当与临床判断和患者偏好相结合时,对CDS存在有利的看法.
- 显著的障碍包括临床医生的抵抗,组织的批准,基础设施和资源.
- 关键的实施策略包括证据传播,EMR集成和用户友好的接口.
结论:
- CDS工具可以提高诊断的准确性,并在初级保健中个性化治疗.
- 考虑EMR集成的CDS包括有效性证据,数据安全性,工作流集成和临床医生负担.
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