Duke Jon D, Morea Justin, Mamlin Burke, Martin Douglas K, Simonaitis Linas, Takesue Blaine Y, Dixon Brian E, Dexter Paul R
Regenstrief Institute Inc., Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA; School of Informatics and Computing, IUPUI, Indianapolis, IN, USA; Wishard/Eskenazi Health Services, Indianapolis, IN, USA.
Regenstrief Institute Inc., Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA; Wishard/Eskenazi Health Services, Indianapolis, IN, USA.
Int J Med Inform. 2014 Mar;83(3):170-9. doi: 10.1016/j.ijmedinf.2013.11.004. Epub 2013 Dec 14.
Regenstrief Institute developed one of the seminal computerized order entry systems, the Medical Gopher, for implementation at Wishard Hospital nearly three decades ago. Wishard Hospital and Regenstrief remain committed to homegrown software development, and over the past 4 years we have fully rebuilt Gopher with an emphasis on usability, safety, leveraging open source technologies, and the advancement of biomedical informatics research. Our objective in this paper is to summarize the functionality of this new system and highlight its novel features.
Applying a user-centered design process, the new Gopher was built upon a rich-internet application framework using an agile development process. The system incorporates order entry, clinical documentation, result viewing, decision support, and clinical workflow. We have customized its use for the outpatient, inpatient, and emergency department settings.
The new Gopher is now in use by over 1100 users a day, including an average of 433 physicians caring for over 3600 patients daily. The system includes a wizard-like clinical workflow, dynamic multimedia alerts, and a familiar 'e-commerce'-based interface for order entry. Clinical documentation is enhanced by real-time natural language processing and data review is supported by a rapid chart search feature.
As one of the few remaining academically developed order entry systems, the Gopher has been designed both to improve patient care and to support next-generation informatics research. It has achieved rapid adoption within our health system and suggests continued viability for homegrown systems in settings of close collaboration between developers and providers.
近三十年前，Regenstrief研究所开发了开创性的计算机化医嘱录入系统之一——医学地鼠系统（Medical Gopher），用于Wishard医院。Wishard医院和Regenstrief研究所仍致力于自主软件开发，在过去4年里，我们对医学地鼠系统进行了全面重建，重点关注可用性、安全性、利用开源技术以及推进生物医学信息学研究。本文的目的是总结这个新系统的功能并突出其新特性。
采用以用户为中心的设计流程，新的医学地鼠系统基于富互联网应用框架，运用敏捷开发流程构建。该系统整合了医嘱录入、临床文档记录、结果查看、决策支持和临床工作流程。我们针对门诊、住院和急诊科环境对其使用进行了定制。
新的医学地鼠系统现在每天有超过1100名用户使用，其中平均有433名医生，他们每天照料超过3600名患者。该系统包括类似向导的临床工作流程、动态多媒体警报以及用于医嘱录入的类似“电子商务”的熟悉界面。临床文档记录通过实时自然语言处理得到增强，快速图表搜索功能支持数据审查。
作为少数几个仍由学术机构开发的医嘱录入系统之一，医学地鼠系统的设计目的既是为了改善患者护理，也是为了支持下一代信息学研究。它在我们的医疗系统中迅速得到采用，表明在开发者和提供者密切合作的环境中，自主开发的系统仍具有持续的可行性。
