Schadow G, Russler D C, Mead C N, McDonald C J
Regenstrief Institute and Department of Medicine, Indiana University, Indianapolis, IN, USA.
Proc AMIA Symp. 2000:764-8.
Guidelines have a proven ability to improve quality of health care and reduce cost, yet, guidelines are not very well deployed at the point of care. This is largely due to the impedance mismatch between decision support modules and the Electronic Medical Record (EMR.) The Unified Service Action Model (USAM) as part of the HL7's Reference Information Model provides a conceptual integration between patient data and medical knowledge. The USAM defines one action-oriented information structure for patient data, concept definitions, action plans, conditionals, and goals. This suggests a new approach to the problem of sharing data and knowledge, effectively working around the problem of missing domain terminology.
指南已被证明有能力提高医疗保健质量并降低成本，然而，指南在医疗服务点的应用情况并不理想。这在很大程度上是由于决策支持模块与电子病历（EMR）之间存在阻抗失配。作为HL7参考信息模型一部分的统一服务行动模型（USAM）提供了患者数据与医学知识之间的概念性整合。USAM为患者数据、概念定义、行动计划、条件语句和目标定义了一种面向行动的信息结构。这为解决数据和知识共享问题提出了一种新方法，有效地避开了领域术语缺失的问题。
