个性化数字护理路径可实现医疗保健专业人员所认为的强化患者管理：混合方法研究。

Personalized Digital Care Pathways Enable Enhanced Patient Management as Perceived by Health Care Professionals: Mixed-Methods Study.

作者信息

Rodrigues David, Jasmins Clara, Ladeiras-Lopes Ricardo, Patrao Luis, Rodrigues Eduardo Freire

机构信息

Comprehensive Health Research Centre, NOVA Medical School, Lisbon, Portugal.

Family Medicine Department, NOVA Medical School, Lisbon, Portugal.

出版信息

JMIR Hum Factors. 2025 May 15;12:e68581. doi: 10.2196/68581.

DOI:10.2196/68581

PMID:40373224

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12097650/

Abstract

BACKGROUND

Clinical decision support systems are known to improve adherence to clinical practice guidelines and patient outcomes by providing clinicians with timely, accurate, and appropriate knowledge.

OBJECTIVE

This study investigates the perceived usefulness and practical implementation of UpHill Route v3, a personalized digital care pathway (PDCP) system, in enhancing clinical decision-making and patient management across various clinical settings.

METHODS

A mixed-methods retrospective study was conducted among medical doctors and nurses from four National Health System-Local Health Units in Portugal. Data were collected from May 2023 to April 2024. The primary data source was an anonymous questionnaire assessing health care professionals' perceptions of UpHill Route v3's usefulness using the Likert scale ranging from 0 (do not agree) to 10 (totally agree). Secondary analysis involved quantifying decisions across heart failure, multimorbidity, diabetes, and colorectal and breast cancer clinical pathways. These data were collected from user interactions with UpHill Route v3 as well as from its internal database. Descriptive and bivariate statistics were used to analyze the data.

RESULTS

A total of 22 health care professionals with mean age 44.7 (SD 10.6) years, including 15 (68%) female participants and 9 (41%) physicians were included in the study. High ratings for adherence to clinical protocols, mean score 8.06 (SD 1.73); clinical decision support, mean score 8.05 (SD 1.73); patient care improvement, mean score 7.63 (SD 2.22); and confidence in patient management, mean score 8.26 (SD 1.56) were reported. Secondary analysis showed that across 3574 patients, 25,741 clinical decisions were informed, and 9254 actions were performed with the assistance of the PDCP tool.

CONCLUSIONS

The UpHill Route v3 PDCP tool is highly valued by health care professionals for its ability to support clinical decision-making and improve operational efficiency across various clinical settings. Our findings suggest that this tool can effectively bridge the gap between clinical guidelines and real-world practice.

摘要

背景

临床决策支持系统通过为临床医生提供及时、准确和恰当的知识，已知可提高对临床实践指南的依从性并改善患者结局。

目的

本研究调查了个性化数字护理路径（PDCP）系统UpHill Route v3在增强不同临床环境下的临床决策和患者管理方面的感知有用性和实际实施情况。

方法

对来自葡萄牙四个国家卫生系统 - 地方卫生单位的医生和护士进行了一项混合方法回顾性研究。数据收集时间为2023年5月至2024年4月。主要数据来源是一份匿名问卷，使用从0（不同意）到10（完全同意）的李克特量表评估医疗保健专业人员对UpHill Route v3有用性的看法。二次分析包括对心力衰竭、多重疾病、糖尿病以及结直肠癌和乳腺癌临床路径中的决策进行量化。这些数据是从用户与UpHill Route v3的交互以及其内部数据库中收集的。使用描述性和双变量统计分析数据。

结果

共有22名医疗保健专业人员参与研究，平均年龄44.7（标准差10.6）岁，其中包括15名（68%）女性参与者和9名（41%）医生。报告显示在遵守临床方案方面评分较高，平均得分为8.06（标准差1.73）；临床决策支持方面，平均得分为8.05（标准差1.73）；患者护理改善方面，平均得分为7.63（标准差2.22）；以及患者管理信心方面，平均得分为8.26（标准差1.56）。二次分析表明，在3574名患者中，有25741项临床决策得到了信息支持，并在PDCP工具的协助下执行了9254项操作。