基于网络的临床决策支持系统的可用性如何有可能导致不良医疗事件。
How usability of a web-based clinical decision support system has the potential to contribute to adverse medical events.
作者信息
Graham Timothy A D, Kushniruk Andre W, Bullard Michael J, Holroyd Brian R, Meurer David P, Rowe Brian H
机构信息
Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, Alberta, Canada.
出版信息
AMIA Annu Symp Proc. 2008 Nov 6;2008:257-61.
INTRODUCTION
Clinical decision support systems (CDSS) have the potential to reduce adverse medical events, but improper design can introduce new forms of error. CDSS pertaining to community acquired pneumonia and neutropenic fever were studied to determine whether usability of the graphical user interface might contribute to potential adverse medical events.
METHODS
Automated screen capture of 4 CDSS being used by volunteer emergency physicians was analyzed using structured methods.
RESULTS
422 events were recorded over 56 sessions. In total, 169 negative comments, 55 positive comments, 130 neutral comments, 21 application events, 34 problems, 6 slips, and 5 mistakes were identified. Three mistakes could have had life-threatening consequences.
CONCLUSION
Evaluation of CDSS will be of utmost importance in the future with increasing use of electronic health records. Usability engineering principles can identify interface problems that may lead to potential medical adverse events, and should be incorporated early in the software design phase.
引言
临床决策支持系统（CDSS）有潜力减少不良医疗事件，但设计不当可能会引入新的错误形式。对与社区获得性肺炎和中性粒细胞减少性发热相关的CDSS进行了研究，以确定图形用户界面的可用性是否可能导致潜在的不良医疗事件。
方法
使用结构化方法分析了志愿急诊医生使用的4个CDSS的自动屏幕截图。
结果
在56次会话中记录了422个事件。总共识别出169条负面评论、55条正面评论、130条中性评论、21个应用事件、34个问题、6次失误和5个错误。其中三个错误可能会导致危及生命的后果。
结论
随着电子健康记录的使用增加，未来对CDSS的评估将至关重要。可用性工程原则可以识别可能导致潜在医疗不良事件的界面问题，并且应该在软件设计阶段尽早纳入。
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