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基层医疗中决策支持的信息需求与要求:慢性疼痛护理分析

Information Needs and Requirements for Decision Support in Primary Care: An Analysis of Chronic Pain Care.

作者信息

Harle Christopher A, Apathy Nate C, Cook Robert L, Danielson Elizabeth C, DiIulio Julie, Downs Sarah M, Hurley Robert W, Mamlin Burke W, Militello Laura G, Anders Shilo

机构信息

Indiana University, Indianapolis, IN, USA.

Regenstrief Institute, Indianapolis, IN, USA.

出版信息

AMIA Annu Symp Proc. 2018 Dec 5;2018:527-534. eCollection 2018.

Abstract

Decision support system designs often do not align with the information environments in which clinicians work. These work environments may increase Clinicians' cognitive workload and harm their decision making. The objective of this study was to identify information needs and decision support requirements for assessing, diagnosing, and treating chronic noncancer pain in primary care. We conducted a qualitative study involving 30 interviews with 10 primary care clinicians and a subsequent multidisciplinary systems design workshop. Our analysis identified four key decision requirements, eight clinical information needs, and four decision support design seeds. Our findings indicate that clinicians caring for chronic pain need decision support that aggregates many disparate information elements and helps them navigate and contextualize that information. By attending to the needs identified in this study, decision support designers may improve Clinicians' efficiency, reduce mental workload, and positively affect patient care quality and outcomes.

摘要

决策支持系统的设计往往与临床医生的工作信息环境不一致。这些工作环境可能会增加临床医生的认知工作量,并损害他们的决策。本研究的目的是确定在初级保健中评估、诊断和治疗慢性非癌性疼痛的信息需求和决策支持要求。我们进行了一项定性研究,对10名初级保健临床医生进行了30次访谈,并随后举办了一次多学科系统设计研讨会。我们的分析确定了四个关键决策要求、八个临床信息需求和四个决策支持设计要点。我们的研究结果表明,照顾慢性疼痛患者的临床医生需要决策支持,这种支持能整合许多不同的信息元素,并帮助他们梳理这些信息并将其置于具体情境中。通过关注本研究中确定的需求,决策支持系统的设计者可能会提高临床医生的效率,减轻心理负担,并对患者护理质量和结果产生积极影响。

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