临床决策支持系统的一些意外后果。
Some unintended consequences of clinical decision support systems.
作者信息
Ash Joan S, Sittig Dean F, Campbell Emily M, Guappone Kenneth P, Dykstra Richard H
机构信息
Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
出版信息
AMIA Annu Symp Proc. 2007 Oct 11;2007:26-30.
Abstract
Clinical decision support systems (CDS) coupled with computerized physician/provider order entry (CPOE) can improve the quality of patient care and the efficiency of hospital operations. However, they can also produce unintended consequences. Using qualitative methods, a multidisciplinary team gathered and analyzed data about the unintended consequences of CPOE, identifying nine types, and found that CDS-generated unintended consequences appeared among all types. Further analysis of 47 CDS examples uncovered three themes related to CDS content: elimination or shifting of human roles; difficulty in keeping content current; and inappropriate content. Three additional themes related to CDS presentation were found: rigidity of the system; alert fatigue; and potential for errors. Management of CDS must include careful selection and maintenance of content and prudent decision making about human computer interaction opportunities.
摘要
临床决策支持系统（CDS）与计算机化医师/提供者医嘱录入系统（CPOE）相结合，可以提高患者护理质量和医院运营效率。然而，它们也可能产生意想不到的后果。一个多学科团队采用定性方法收集并分析了有关CPOE意外后果的数据，识别出九种类型，并发现CDS产生的意外后果在所有类型中都有出现。对47个CDS实例的进一步分析揭示了与CDS内容相关的三个主题：人类角色的消除或转变；内容更新困难；以及内容不当。还发现了与CDS呈现相关的另外三个主题：系统的僵化；警报疲劳；以及出错的可能性。CDS的管理必须包括对内容的精心选择和维护，以及在人机交互机会方面的审慎决策。
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