关于CDS故障的专题:利用用户反和系统验证的两阶段框架,以改善后期临床决策支持
Wendi Zhao1, Xuetao Wang1, Kevin Afra2,3
1Infection Prevention and Control, Fraser Health Authority, Surrey, Canada.
Applied clinical informatics
|June 30, 2025
概括
一个新的框架有效地识别了医疗保健机构的临床决策支持 (CDS) 功能障碍,揭示了低于2%的低患病率,并突出了电子健康记录升级期间的风险.
科学领域:
- 医疗信息学 医疗信息学
- 医疗错误管理 医疗错误管理
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 临床决策支持 (CDS) 系统提供了好处,但面临着故障的风险.
- 在动态的医疗环境中评估现场CDS性能缺乏标准化的方法.
- 目前用户对CDS业绩的看法仍然有限.
研究的目的:
- 提出一个全面的框架,用于识别和评估现场后的CDS故障.
- 从医疗保健机构的角度评估CDS绩效.
- 为CDS问题提供客观见解,提高系统性能.
主要方法:
- 开发了一个两阶段的框架:实时用户反和系统的数据库验证.
- 系统验证包括数据流,知识和规则验证.
- 测量包括身份,完整性,可信性和跨地点和时间的一致性.
主要成果:
- 在加拿大的14个急性护理机构,在两年内发现了7种类型的CDS故障.
- 整体故障率低于2%.
- 在电子健康记录 (EHR) 升级和实施阶段观察到越来越多的故障.
结论:
- 拟议的框架使CDS在医疗保健机构的表现能够全面评估.
- 它提供了客观的洞察力对故障的流行,包括低频率的问题.
- 应用这个框架可以提高CDS的可靠性和用户的信任.
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