Wright Adam, Bates David W, Middleton Blackford, Hongsermeier Tonya, Kashyap Vipul, Thomas Sean M, Sittig Dean F
Clinical Informatics Research & Development, Partners HealthCare System, 93 Worcester St., Wellesely, Boston, MA 02481, USA.
J Biomed Inform. 2009 Apr;42(2):334-46. doi: 10.1016/j.jbi.2008.09.003. Epub 2008 Oct 8.
Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.
临床决策支持是提高医疗质量和患者安全的有力工具。然而，开发一套全面的决策支持干预措施成本高昂且困难重重。如果运用得当，Web 2.0方法可能会使决策支持的开发变得更加容易且成本更低。Web 2.0的特点是在线社区、开放共享、交互性和协作性。尽管此前大多数分享临床决策支持内容的尝试都是在Web 2.0框架之外进行的，但已有多项举措开始利用Web 2.0来分享决策支持内容并开展协作。我们介绍三项工作的案例研究：Clinfowiki，一个可供全球访问的用于开发决策支持内容的维基；Partners Healthcare eRooms，用于在单个组织内开发决策支持的基于网络的工具；以及Epic Systems Corporation的社区图书馆，一个为单一临床系统供应商的客户分享决策支持内容的知识库。我们通过三个案例研究来评估Web 2.0技术在促进临床决策支持系统的协作开发和共享方面的潜力；分析Web 2.0环境下临床决策支持内容的开发者、使用者和组织者所面临的技术、法律和组织问题。我们认为，Web 2.0作为临床决策支持内容协作工具的理由似乎很充分，尤其是在组织内部进行协作内容开发方面。
