Bobb Anne M, Payne Thomas H, Gross Peter A
Department of Quality and Operations, Northwestern Memorial Hospital, Chicago, IL 60611, USA.
J Am Med Inform Assoc. 2007 Jan-Feb;14(1):41-7. doi: 10.1197/jamia.M2184. Epub 2006 Oct 26.
Order sets provide straightforward clinical decision support within computerized provider order entry systems. They make "the right thing" easier to do because they are much faster than writing single orders; they deliver real-time, evidence-based prompts; they are easy to update; and they support coverage of multiple patient problems through linkages among order sets. This viewpoint paper discusses controversies surrounding use of order sets--advantages and pitfalls, decision-making criteria, and organizational considerations, including suggestions for vendors. Order sets have the potential to improve clinician efficiency, provide real-time guidance, facilitate compliance with Joint Commission on Accreditation of Healthcare Organizations and Centers for Medicare and Medicaid Services performance measure sets, and encourage overall acceptance of computerized provider order entry, but may not do so unless these controversies are addressed.
医嘱集在计算机化医嘱录入系统中提供直接的临床决策支持。它们使“正确的事”更易于做到，因为它们比逐个书写医嘱快得多；它们提供实时、基于证据的提示；易于更新；并且通过医嘱集之间的关联支持对多个患者问题的覆盖。这篇观点论文讨论了围绕医嘱集使用的争议——优点与缺陷、决策标准以及组织方面的考虑，包括对供应商的建议。医嘱集有潜力提高临床医生的效率，提供实时指导，促进符合医疗组织评审联合委员会以及医疗保险和医疗补助服务中心的绩效指标集，并鼓励对计算机化医嘱录入的全面接受，但除非解决这些争议，否则可能无法实现这些目标。
