Jacobs Jason, Narus Scott P, Evans R Scott, Staes Catherine J
Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah.
Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah; Intermountain Healthcare, Salt Lake City, Utah.
AMIA Annu Symp Proc. 2015 Nov 5;2015:1918-26. eCollection 2015.
Post-liver transplant patients require lifelong immunosuppressive care and monitoring. Computerized alerts can aid laboratory monitoring, but it is unknown how the distribution of alerts changes over time. We describe the changes over time of the distribution of computerized alerts for laboratory monitoring of post-liver transplant immunosuppressive care. Data were collected for post-liver transplant patients transplanted and managed at Intermountain Healthcare between 2005 and 2012. Alerts were analyzed based on year triggered, time since transplantation, hospitalization status, alert type, action taken (accepted or rejected), reason given for the action taken, and narrative comments. Alerts for overdue laboratory testing became more prevalent as time since transplantation increased. There is an increased need to support monitoring for overdue laboratory testing as the time since transplantation increases. Alerts should support providers as they monitor the evolving needs of post-transplant patients over time. We identify opportunities for improving laboratory monitoring of post-liver transplant patients.
肝移植术后患者需要终身免疫抑制治疗及监测。计算机化警报有助于实验室监测，但警报的分布随时间如何变化尚不清楚。我们描述了肝移植术后免疫抑制治疗实验室监测的计算机化警报分布随时间的变化情况。收集了2005年至2012年在山间医疗保健机构接受移植并进行管理的肝移植术后患者的数据。根据触发年份、移植后时间、住院状态、警报类型、采取的行动（接受或拒绝）、采取该行动的原因以及叙述性评论对警报进行分析。随着移植后时间的增加，逾期实验室检测警报变得更加普遍。随着移植后时间的增加，对逾期实验室检测监测的支持需求也在增加。随着时间的推移，当医疗服务提供者监测移植后患者不断变化的需求时，警报应提供支持。我们确定了改善肝移植术后患者实验室监测的机会。
