Respiratory Division, The George Institute for Global Health, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Australia.
Stud Health Technol Inform. 2021 May 7;279:149-156. doi: 10.3233/SHTI210103.
Clinical decision support systems (CDSS) have been shown in a variety of diseases to lead to improvements in care. The aim of this study is to design a CDSS to assist GPs to assess and manage breathlessness, a highly prevalent symptom in practice. A focus group is conducted to explore the needs of general practitioners (GPs), assess current workflow to identify points for intervention and develop early prototypes for testing. Five GPs took part in the focus group elucidating 248 relevant data points which were then qualitatively analyzed using the Technology Acceptance Model as the theoretical framework. In general, there was a positive attitude towards the use of CDSS for breathlessness with various proposed features from the participants. Twelve high level workflow steps were identified with 5 as key points for intervention. Several proposed features such as reporting likelihood of causes of breathlessness in a patient, link with evidence-based recommendations, integration with clinical notes and patient education materials were translated into a prototype. Mixed-method studies are planned to assess its usability to inform subsequent iterations of the CDSS development.
临床决策支持系统（CDSS）已在多种疾病中被证明可改善护理。本研究旨在设计一个 CDSS 以帮助全科医生评估和管理呼吸困难，这是一种在实践中非常普遍的症状。通过焦点小组探讨全科医生的需求，评估当前的工作流程以确定干预点，并开发早期原型进行测试。五名全科医生参加了焦点小组，阐述了 248 个相关数据点，然后使用技术接受模型作为理论框架对其进行定性分析。一般来说，医生对使用 CDSS 来处理呼吸困难持积极态度，并提出了各种建议。确定了 12 个高级工作流程步骤，其中 5 个是干预的关键点。一些提出的功能，如报告患者呼吸困难的原因的可能性、与循证建议的链接、与临床记录和患者教育材料的整合，被转化为一个原型。计划进行混合方法研究来评估其可用性，以为后续的 CDSS 开发迭代提供信息。
