Department of Biomedical Informatics, Vanderbilt University Medical Center, USA; Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center, USA.
Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA; Wisconsin Institute for Healthcare Systems Engineering, University of Wisconsin-Madison, USA.
Appl Ergon. 2021 Nov;97:103498. doi: 10.1016/j.apergo.2021.103498. Epub 2021 Jun 26.
Numerous challenges with the implementation, acceptance, and use of health IT are related to poor usability and a lack of integration of the technologies into clinical workflow, and have, therefore, limited the potential of these technologies to improve patient safety. We propose a definition and conceptual model of health IT workflow integration. Using interviews of 12 emergency department (ED) physicians, we identify 134 excerpts of barriers and facilitators to workflow integration of a human factors (HF)-based clinical decision support (CDS) implemented in the ED. Using data on these 134 barriers and facilitators, we distinguish 25 components of workflow integration of the CDS, which are described according to four dimensions of workflow integration: time, flow, scope of patient journey, and level. The proposed definition and conceptual model of workflow integration can be used to inform health IT design; this is the purpose of the proposed checklist that can help to ensure consideration of workflow integration during the development of health IT.
医疗信息技术实施、接受和使用中存在诸多挑战，这与可用性差以及技术未能融入临床工作流程有关，因此限制了这些技术改善患者安全的潜力。我们提出了医疗信息技术工作流程整合的定义和概念模型。通过对 12 名急诊医师的访谈，我们确定了在急诊科实施基于人为因素的临床决策支持（CDS）时，工作流程整合的 134 个障碍和促进因素片段。利用这些 134 个障碍和促进因素的数据，我们区分了 CDS 工作流程整合的 25 个组成部分，这些部分根据工作流程整合的四个维度进行描述：时间、流程、患者旅程范围和层次。所提出的工作流程整合定义和概念模型可用于为医疗信息技术设计提供信息；这就是拟议检查表的目的，它可以帮助确保在开发医疗信息技术时考虑工作流程整合。
