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肝脏移植中用于优化护理交付的信息学驱动解决方案。

Informatics-driven solutions for optimal care delivery in liver transplantation.

作者信息

Spann Ashley, Louissaint Jeremy, Izzy Manhal

机构信息

Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Liver Transpl. 2024 Aug 26. doi: 10.1097/LVT.0000000000000471.

Abstract

Clinical informatics, which combines health information technology and clinical expertise, aims to improve health care delivery and outcomes. For candidates and recipients of liver transplants, the complexities of their management are vast. Care often involves significant volumes of data from various sources and multiple health care settings and health care systems. Informatics represents an opportunity to support the care of these patients through this process; however, it has been underutilized to date. Preliminary examples of informatics use exist for this patient population, such as clinical decision support to link patients to hepatology providers, utilization of digital health technologies to track responses to medical therapy, and artificial intelligence to characterize organ donor compatibility. Further deployment of these tools can optimize care delivery for patients with cirrhosis and across the transplant cascade. In this review, we explore the utility of various techniques of clinical informatics mainly within the transplant care cascade, barriers to implementation, and highlight opportunities for future investigation and optimized use. Although barriers to widespread adoption remain such as interoperability, data access and availability, and structured implementation strategies, the integration of informatics and clinical decision support/artificial intelligence-based tools into routine care for liver transplantation represents an opportunity for marked enhancement in how we deliver care to these patients.

摘要

临床信息学将健康信息技术与临床专业知识相结合,旨在改善医疗服务的提供和结果。对于肝移植的候选者和接受者而言,他们的管理复杂性极大。护理通常涉及来自各种来源以及多个医疗环境和医疗系统的大量数据。信息学为在此过程中支持这些患者的护理提供了契机;然而,到目前为止其尚未得到充分利用。针对这一患者群体,已有信息学应用的初步实例,例如用于将患者与肝病专家联系起来的临床决策支持、利用数字健康技术跟踪药物治疗反应以及利用人工智能来确定器官供体的兼容性。进一步部署这些工具可以优化肝硬化患者及整个移植过程的护理服务。在本综述中,我们主要探讨了临床信息学的各种技术在移植护理过程中的效用、实施障碍,并强调了未来研究和优化使用的机会。尽管广泛采用仍存在障碍,如互操作性、数据访问和可用性以及结构化实施策略,但将信息学和基于临床决策支持/人工智能的工具整合到肝移植的常规护理中,为我们改善这些患者的护理方式提供了显著提升的机会。

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