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临床信息学加速了医疗体系对 COVID-19 大流行的适应:来自科罗拉多州的案例。

Clinical informatics accelerates health system adaptation to the COVID-19 pandemic: examples from Colorado.

机构信息

Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.

Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.

出版信息

J Am Med Inform Assoc. 2020 Dec 9;27(12):1955-1963. doi: 10.1093/jamia/ocaa171.

Abstract

OBJECTIVE

Large health systems responding to the coronavirus disease 2019 (COVID-19) pandemic face a broad range of challenges; we describe 14 examples of innovative and effective informatics interventions.

MATERIALS AND METHODS

A team of 30 physician and 17 nurse informaticists with an electronic health record (EHR) and associated informatics tools.

RESULTS

To meet the demands posed by the influx of patients with COVID-19 into the health system, the team built solutions to accomplish the following goals: 1) train physicians and nurses quickly to manage a potential surge of hospital patients; 2) build and adjust interactive visual pathways to guide decisions; 3) scale up video visits and teach best-practice communication; 4) use tablets and remote monitors to improve in-hospital and posthospital patient connections; 5) allow hundreds of physicians to build rapid consensus; 6) improve the use of advance care planning; 7) keep clinicians aware of patients' changing COVID-19 status; 8) connect nurses and families in new ways; 9) semi-automate Crisis Standards of Care; and 10) predict future hospitalizations.

DISCUSSION

During the onset of the COVID-19 pandemic, the UCHealth Joint Informatics Group applied a strategy of "practical informatics" to rapidly translate critical leadership decisions into understandable guidance and effective tools for patient care.

CONCLUSION

Informatics-trained physicians and nurses drew upon their trusted relationships with multiple teams within the organization to create practical solutions for onboarding, clinical decision-making, telehealth, and predictive analytics.

摘要

目的

应对 2019 年冠状病毒病(COVID-19)大流行的大型卫生系统面临着广泛的挑战;我们描述了 14 种创新且有效的信息学干预措施的示例。

材料和方法

一个由 30 名医师和 17 名护士信息学家组成的团队,拥有电子健康记录(EHR)和相关的信息学工具。

结果

为了满足 COVID-19 患者涌入卫生系统带来的需求,该团队构建了解决方案以实现以下目标:1)快速培训医生和护士以管理潜在的医院患者激增;2)构建和调整互动式视觉路径以指导决策;3)扩大视频访问并教授最佳沟通技巧;4)使用平板电脑和远程监视器改善住院和出院后患者的联系;5)允许数百名医生快速达成共识;6)改善预先护理计划的使用;7)使临床医生了解患者 COVID-19 状况的变化;8)以新的方式连接护士和家庭;9)半自动化危机护理标准;和 10)预测未来的住院治疗。

讨论

在 COVID-19 大流行期间,UCHealth 联合信息学小组应用了“实用信息学”策略,迅速将关键领导决策转化为可理解的患者护理指南和有效工具。

结论

接受过信息学培训的医师和护士利用他们与组织内多个团队的信任关系,为入职、临床决策、远程医疗和预测分析创建了实用的解决方案。

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