Lewis Janet, Hongsermeier Tonya M, Middleton Blackford, Bell Douglas S
Rand Health Q. 2012 Jun 1;2(2):11. eCollection 2012 Summer.
This article, by researchers from Partners HealthCare and the RAND Corporation, primarily describes the work associated with Task 4.8 of the Advancing Clinical Decision Support (ACDS) effort, a project intended to accelerate the effective use of computer-based clinical decision support (CDS) interventions to facilitate evidence-based clinical practice and the meaningful use of health information technology. The key objectives of Task 4.8 were to develop CDS artifacts for at least 20 interventions of different types, targeted toward guidelines and clinical conditions called for in the 2011 meaningful use criteria, and to disseminate the tools, content, and materials through a knowledge-sharing service (KSS) that could potentially be deployed on a national scale. The ACDS interventions or artifacts were built utilizing the extensible markup language (XML) schema developed by the Clinical Decision Support Consortium (CDSC) project and were published on the CDSC portal (http://cdsportal.partners.org/), which functions as the ACDS KSS. While the original CDSC Level 3 XML schema adequately supported the development of the ACDS artifacts, the authors worked with the CDSC team to expand the schema to support additional intervention types (order sets, documentation templates, infobuttons, relevant data display, and value sets). Twenty-two CDS artifacts and 16 value sets were developed that cover the five CDS intervention types. Three custom style sheets were developed to render the XML files in human-readable form. The authors recommend investment in the foundational building blocks for shareable CDS, such as dictionaries and value sets, as these will be essential. The CDS content on the portal will need to be expanded and maintained in order for it to remain a viable resource for CDS implementers.
本文由合作伙伴医疗保健公司和兰德公司的研究人员撰写，主要描述了与推进临床决策支持（ACDS）项目任务4.8相关的工作。该项目旨在加速基于计算机的临床决策支持（CDS）干预措施的有效应用，以促进循证临床实践和健康信息技术的有意义使用。任务4.8的主要目标是针对2011年有意义使用标准中要求的指南和临床病症，开发至少20种不同类型干预措施的CDS工件，并通过一个可能在全国范围内部署的知识共享服务（KSS）来传播这些工具、内容和材料。ACDS干预措施或工件是利用临床决策支持联盟（CDSC）项目开发的可扩展标记语言（XML）模式构建的，并发布在CDSC门户网站（http://cdsportal.partners.org/）上，该网站作为ACDS的KSS发挥作用。虽然原始的CDSC 3级XML模式充分支持了ACDS工件的开发，但作者与CDSC团队合作扩展了该模式，以支持更多的干预类型（医嘱集、文档模板、信息按钮、相关数据显示和值集）。开发了22个CDS工件和16个值集，涵盖了五种CDS干预类型。还开发了三个自定义样式表，以便将XML文件呈现为人类可读的形式。作者建议投资于可共享CDS的基础构建模块，如词典和值集，因为这些将至关重要。为使门户网站上的CDS内容仍然是CDS实施者的可行资源，需要对其进行扩展和维护。
