Regier Rachel, Gurjar Rupali, Rocha Roberto A
Knowledge Management, Clinical Informatics Research and Development, Partners HealthCare Systems, Wellesley, MA, USA.
AMIA Annu Symp Proc. 2009 Nov 14;2009:537-41.
Clinical decision support (CDS) implemented as part of an electronic medical record (EMR) has a well-documented history of improving patient safety and quality of care; however, the difficulties of keeping CDS up to date have also been documented. At Partners HealthCare, we initially implemented CDS reminders in our 'homegrown' EMR system as 'hardcoded' rules. The challenges of updating existing rules and implementing new rules in the hard-coded state, however, soon made this model unsustainable. After evaluating our needs and requirements for rule creation and maintenance, we designed and created a browser-based rule editor that would decrease turnaround time for logic changes, allowing us to respond to CDS requests more efficiently. We have been able to maintain the older reminder rules with the rule editor, and have added a number of new reminders. Our work to date has confirmed the strengths of the editor, but has also identified a few limitations.
作为电子病历(EMR)一部分实施的临床决策支持(CDS),在改善患者安全和护理质量方面有着充分的文献记载;然而,保持CDS最新状态的困难也有文献记载。在合作伙伴医疗保健公司,我们最初在我们的“自主开发”电子病历系统中作为“硬编码”规则实施CDS提醒。然而,在硬编码状态下更新现有规则和实施新规则的挑战,很快使这种模式难以为继。在评估了我们对规则创建和维护的需求后,我们设计并创建了一个基于浏览器的规则编辑器,它将减少逻辑更改的周转时间,使我们能够更高效地响应CDS请求。我们已经能够使用规则编辑器维护旧的提醒规则,并添加了一些新的提醒。我们迄今为止的工作证实了编辑器的优点,但也发现了一些局限性。