Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
J Am Med Inform Assoc. 2022 Nov 14;29(12):2124-2127. doi: 10.1093/jamia/ocac151.
Monkeypox virus was historically rare outside of West and Central Africa until the current 2022 global outbreak, which has required clinicians to be alert to identify individuals with possible monkeypox, institute isolation, and take appropriate next steps in evaluation and management. Clinical decision support systems (CDSS), which have been shown to improve adherence to clinical guidelines, can support frontline clinicians in applying the most current evaluation and management guidance in the setting of an emerging infectious disease outbreak when those guidelines are evolving over time. Here, we describe the rapid development and implementation of a CDSS tool embedded in the electronic health record to guide frontline clinicians in the diagnostic evaluation of monkeypox infection and triage patients with potential monkeypox infection to individualized infectious disease physician review. We also present data on the initial performance of this tool in a large integrated healthcare system.
猴痘病毒在 2022 年全球疫情爆发之前，历史上主要局限于西非和中非地区。此次疫情要求临床医生保持警惕，识别可能患有猴痘的患者，进行隔离，并在评估和管理方面采取适当的后续措施。临床决策支持系统（CDSS）已被证明可以提高临床指南的依从性，当指南随着时间的推移而不断变化时，它可以支持一线临床医生在新发传染病疫情期间应用最新的评估和管理指南。在这里，我们描述了一个嵌入电子健康记录中的 CDSS 工具的快速开发和实施，以指导一线临床医生对猴痘感染进行诊断评估，并对疑似猴痘感染的患者进行分诊，以便接受个体化的传染病医生评估。我们还介绍了在一个大型综合医疗系统中该工具的初步性能数据。
