Systems Research Institute, Polish Academy of Sciences, 00-001 Warsaw, Poland.
Faculty of Business and International Relations, Vistula University, 02-787 Warsaw, Poland.
Int J Environ Res Public Health. 2019 Jul 24;16(15):2638. doi: 10.3390/ijerph16152638.
The aim of the study is to indicate the need for variability in the presentation of clinical pathways, in various phases of their implementation, and to define the forms of presentation of clinical pathways required by physicians in both the Hospital Information Systems (HIS) and Electronic Medical Records (EMR) Systems, as well as the determinants of the selection of the forms of description, in relation to the performed medical actions. The results of the study are a significant lead-in towards further research on the required form of the user interface in systems supporting dynamic business process management (dynamic BPM). The research is a pilot of a survey study, conducted to ascertain the usefulness and feasibility of the adopted methodology, for a wider project on the determinants of the form of description of clinical pathways. An exploratory pilot survey, in a large multi-specialization hospital in Poland, was conducted. The survey sample consisted of 28 purposely selected heads of all hospital departments, and the medical team of the pediatric ward. Descriptive analysis was carried out on the data collected. The results of the study have unambiguously supported the claim that physicians require the form of presentation of clinical pathways to change, depending on the particular phase of the diagnostic-therapeutic process, as well as establishing the main determinants thereof. This pilot study is one of the first attempts to establish the factors determining the choice of clinical pathway presentation in HIS/EMR systems. While not conclusively decisive in terms of the forms of presentation or the determinants of their choice, it indicates the directions of further research, both from the point of view of ergonomics and the usability of HIS/EMR systems, as well as the management of medical knowledge, as part of the dynamic management of clinical pathways.
本研究旨在指出临床路径在实施的不同阶段呈现方式需要具有变异性，并定义医师在医院信息系统（HIS）和电子病历（EMR）系统中所需的临床路径呈现形式，以及与所执行的医疗操作相关的选择描述形式的决定因素。该研究结果为进一步研究支持动态业务流程管理（动态 BPM）的系统所需的用户界面形式提供了重要依据。该研究是一项调查研究的试点，旨在确定所采用方法的有用性和可行性，以便更广泛地开展关于临床路径描述形式决定因素的项目。在波兰的一家大型多专科医院进行了探索性试点调查。调查样本由 28 名精心挑选的医院各科室主任和儿科病房的医疗团队组成。对收集的数据进行了描述性分析。研究结果明确支持了以下主张，即医师需要根据诊断-治疗过程的特定阶段改变临床路径的呈现形式，并确定其主要决定因素。这项试点研究是首次尝试确定在 HIS/EMR 系统中选择临床路径呈现形式的因素。虽然在呈现形式或选择其的决定因素方面没有最终决定性，但它指出了进一步研究的方向，既从人体工程学和 HIS/EMR 系统的可用性的角度，也从医疗知识管理的角度，作为临床路径动态管理的一部分。
