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行为医学视角下的健康信息技术设计,以改善慢性疼痛管理中的决策、指南依从性和护理协调。

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management.

机构信息

Center for Health Care Evaluation, VA Palo Alto HealthCare System, 795 Willow Road (152-MPD), Menlo Park, CA 94025 USA ; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305 USA.

出版信息

Transl Behav Med. 2011 Mar;1(1):35-44. doi: 10.1007/s13142-011-0022-6.

Abstract

Development of clinical decision support systems (CDSs) has tended to focus on facilitating medication management. An understanding of behavioral medicine perspectives on the usefulness of a CDS for patient care can expand CDSs to improve management of chronic disease. The purpose of this study is to explore feedback from behavioral medicine providers regarding the potential for CDSs to improve decision-making, care coordination, and guideline adherence in pain management. Qualitative methods were used to analyze semi-structured interview responses from behavioral medicine stakeholders following demonstration of an existing CDS for opioid prescribing, ATHENA-OT. Participants suggested that a CDS could assist with decision-making by educating providers, providing recommendations about behavioral therapy, facilitating risk assessment, and improving referral decisions. They suggested that a CDS could improve care coordination by facilitating division of workload, improving patient education, and increasing consideration and knowledge of options in other disciplines. Clinical decision support systems are promising tools for improving behavioral medicine care for chronic pain.

摘要

临床决策支持系统(CDSs)的开发往往侧重于促进药物管理。了解行为医学对 CDS 在患者护理方面的有用性的观点,可以扩展 CDS 以改善慢性病的管理。本研究的目的是探讨行为医学提供者对 CDS 在改善疼痛管理中的决策、护理协调和指南依从性的潜在作用的反馈。采用定性方法分析了在展示现有的阿片类药物处方 CDS(ATHENA-OT)后,行为医学利益相关者的半结构化访谈回复。参与者认为,CDS 可以通过教育提供者、提供关于行为疗法的建议、促进风险评估以及改进转诊决策来协助决策。他们认为,CDS 可以通过促进工作量的分配、改善患者教育以及增加对其他学科中各种选择的考虑和了解来改善护理协调。临床决策支持系统是改善慢性疼痛的行为医学护理的有前途的工具。

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