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2016 - 2017年多源健康数据在决策支持科学领域的共享进展

Advances in Sharing Multi-sourced Health Data on Decision Support Science 2016-2017.

作者信息

Shankar Prabhu, Anderson Nick

机构信息

Division of Health Informatics, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA.

出版信息

Yearb Med Inform. 2018 Aug;27(1):16-24. doi: 10.1055/s-0038-1641215. Epub 2018 Aug 29.

Abstract

INTRODUCTION

Clinical decision support science is expanding to include integration from broader and more varied data sources, diverse platforms and delivery modalities, and is responding to emerging regulatory guidelines and increased interest from industry.

OBJECTIVE

Evaluate key advances and challenges of accessing, sharing, and managing data from multiple sources for development and implementation of Clinical Decision Support (CDS) systems in 2016-2017.

METHODS

Assessment of literature and scientific conference proceedings, current and pending policy development, and review of commercial applications nationally and internationally.

RESULTS

CDS research is approaching multiple landmark points driven by commercialization interests, emerging regulatory policy, and increased public awareness. However, the availability of patient-related "Big Data" sources from genomics and mobile health, expanded privacy considerations, applications of service-based computational techniques and tools, the emergence of "app" ecosystems, and evolving patient-centric approaches reflect the distributed, complex, and uneven maturity of the CDS landscape. Nonetheless, the field of CDS is yet to mature. The lack of standards and CDS-specific policies from regulatory bodies that address the privacy and safety concerns of data and knowledge sharing to support CDS development may continue to slow down the broad CDS adoption within and across institutions.

CONCLUSION

Partnerships with Electronic Health Record and commercial CDS vendors, policy makers, standards development agencies, clinicians, and patients are needed to see CDS deployed in the evolving learning health system.

摘要

引言

临床决策支持科学正在不断扩展,涵盖来自更广泛、更多样化数据源的整合,以及多样的平台和交付方式,并且正在响应新出现的监管指南和行业日益增长的兴趣。

目的

评估2016 - 2017年在临床决策支持(CDS)系统的开发和实施过程中,从多个来源获取、共享和管理数据的关键进展与挑战。

方法

评估文献和科学会议论文集、当前和待定的政策制定情况,并审查国内外的商业应用。

结果

受商业化利益、新出现的监管政策以及公众意识提高的推动,CDS研究正接近多个里程碑节点。然而,来自基因组学和移动健康领域的与患者相关的“大数据”源的可用性、隐私考量的扩大、基于服务的计算技术和工具的应用、“应用程序”生态系统的出现以及以患者为中心的方法的不断演变,都反映出CDS格局的分布式、复杂性和成熟度的不均衡。尽管如此,CDS领域仍未成熟。监管机构缺乏针对数据和知识共享的隐私与安全问题以支持CDS开发的标准和特定于CDS的政策,可能会继续减缓CDS在机构内部和机构之间的广泛采用。

结论

需要与电子健康记录和商业CDS供应商、政策制定者、标准制定机构、临床医生以及患者建立合作伙伴关系,以便在不断发展的学习型健康系统中部署CDS。

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