Department of Surgery, University of California, San Diego, La Jolla, California, USA.
Department of Pediatrics, Division of Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
Yearb Med Inform. 2021 Aug;30(1):105-125. doi: 10.1055/s-0041-1726513. Epub 2021 Sep 3.
The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19.
PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced.
CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes.
Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.
2020 年主要受到 2019 年冠状病毒病(COVID-19)大流行的影响。本文的目的是回顾临床信息系统(CIS)可以并且已经用于支持和增强医疗系统应对大流行的各个领域,重点是 COVID-19。
通过 2020 年 10 月,在 PubMed/MEDLINE、Google Scholar、主要信息学杂志的目录和文章的参考文献中搜索了与 CIS、大流行和 COVID-19 相关的研究。突出显示了最具信息性和最详细的研究,同时也引用了许多其他研究。
CIS 在全球范围内的卫生系统和政府机构应对 COVID-19 中得到了广泛的依赖。开发了基于技术的筛查工具来协助快速识别病例并进行适当的分诊。通过使用电子健康记录(EHR)将一线提供者纳入新协议、提供临床决策支持以及改进诊断检测系统,为临床护理提供了支持。远程医疗成为了最近历史上发展最快的医疗趋势,也是安全有效获得医疗服务的重要策略。人工智能和机器学习算法已被开发用于增强筛查、诊断成像和预测分析——尽管改善结果的证据仍然有限。地理信息系统和大数据使实时仪表板成为流行病监测、医院准备策略和卫生政策决策的重要工具。实施了数字接触追踪系统,以协助一项劳动密集型任务,旨在遏制传播。大规模数据共享、有效的健康信息交换和 EHR 的互操作性仍然是信息学社区面临的挑战,但具有巨大的临床和学术潜力。为了有意义地改善患者的结果,CIS 必须与利益相关者和运营变革管理相结合使用。
管理大流行需要广泛、及时和有效地分发可靠信息。在过去的一年中,CIS 和信息学专家在全球应对 COVID-19 大流行的过程中做出了突出而有影响力的贡献。