评估计算机化血液医嘱“会诊”系统的有效性。
Assessing the effectiveness of a computerized blood order "consultation" system.
作者信息
Lepage E F, Gardner R M, Laub R M, Jacobson J T
机构信息
Department of Biostatistics and Medical Informatics, Saint-Louis Hospital/University of Paris VII, France.
出版信息
Proc Annu Symp Comput Appl Med Care. 1991:33-7.
To optimize blood ordering and accurately assess transfusion practice, in 1987, an "on line" computerized, knowledge-based, blood order critiquing system was integrated into the HELP Hospital Information System (HIS) at LDS Hospital. Evaluations of the computerized ordering system demonstrated its benefits and limitations on transfusion practice. Based on this experience, a second generation blood ordering system using a consultation mode was developed. A pilot test of this blood order consultant system, using historical data in the HELP system's database, was performed. This pilot test demonstrated that the consultation system provided accurate recommendations for red blood cell (RBC) and platelet orders. Comparing the appropriateness of blood orders with the recommendations made by the director of the blood bank, the orders recommended by the computer "consultant" agreed 95.5% of the time. The computer consultation system also recommended fewer RBC units for transfusion. Preliminary results obtained using the consultant approach suggest that we may be able to simplify blood ordering practice and also reduce the number of units of blood products ordered. Based on these findings we are now preparing to compare the "critiquing" and "consultation" approaches using a clinical trial.
为优化血液订购并准确评估输血实践，1987年，一个“在线”的计算机化、基于知识的血液订购评判系统被集成到LDS医院的HELP医院信息系统（HIS）中。对该计算机化订购系统的评估显示了其在输血实践中的益处和局限性。基于这一经验，开发了一种使用咨询模式的第二代血液订购系统。利用HELP系统数据库中的历史数据对该血液订购咨询系统进行了试点测试。该试点测试表明，该咨询系统能为红细胞（RBC）和血小板订购提供准确建议。将血液订购的合理性与血库主任的建议进行比较，计算机“顾问”给出的建议在95.5%的情况下是一致的。计算机咨询系统还建议减少红细胞输注单位。使用咨询方法获得的初步结果表明，我们或许能够简化血液订购实践，同时减少所订购血液制品的单位数量。基于这些发现，我们现在正准备通过一项临床试验来比较“评判”和“咨询”方法。
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