将指南计算机化：成功的因素
Computerizing guidelines: factors for success.
作者信息
Tierney W M, Overhage J M, McDonald C J
机构信息
Indiana University School of Medicine, Regenstrief Institute for Health Care, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA.
出版信息
Proc AMIA Annu Fall Symp. 1996:459-62.
Abstract
Clinical practice guidelines are being touted as a cure for the tension between health care cost and quality. Rather than being just a means of controlling clinicians, guidelines also offer the chance to improve the quality of care by reducing practice variation and adherence to standards of good care. To be operationalized via computers, guidelines must be accepted by the clinicians, who must fully intend to follow them. They must be timely and use available data with minimal additional data entry by clinicians. Finally, they should have a measurable effect and be shown to improve care processes and/or outcomes.
摘要
临床实践指南被誉为解决医疗保健成本与质量之间矛盾的良方。指南不仅仅是控制临床医生的一种手段，还提供了通过减少实践差异和遵循优质护理标准来提高护理质量的机会。要通过计算机实施，指南必须得到临床医生的认可，临床医生必须真心打算遵循这些指南。指南必须及时更新，并利用现有数据，尽量减少临床医生额外的数据录入。最后，指南应该产生可衡量的效果，并证明能够改善护理流程和/或护理结果。
相似文献
1
Computerizing guidelines: factors for success.将指南计算机化：成功的因素
Proc AMIA Annu Fall Symp. 1996:459-62.
2
Primary care guidelines from an organizational point of view.从组织角度看基层医疗指南。
Stud Health Technol Inform. 1995;16:97-104.
3
Computerized assessment with primary care guidelines in The Netherlands.荷兰初级保健指南的计算机化评估。
Stud Health Technol Inform. 1995;16:87-95.
4
The development of protocols to cover clinical care in cardiology.
Stud Health Technol Inform. 1995;16:135-44.
5
A multiple-scenario assessment of the effect of a continuous-care, guideline-based decision support system on clinicians' compliance to clinical guidelines.基于指南的持续护理决策支持系统对临床医生遵循临床指南情况影响的多情景评估。
Int J Med Inform. 2015 Apr;84(4):248-62. doi: 10.1016/j.ijmedinf.2015.01.004. Epub 2015 Jan 17.
6
Informatics in radiology: Measuring and improving quality in radiology: meeting the challenge with informatics.放射学中的信息学：测量和提高放射学质量：用信息学迎接挑战。
Radiographics. 2011 Oct;31(6):1511-27. doi: 10.1148/rg.316105207.
7
From guidelines to decision support in the management of asthma.从哮喘管理的指南到决策支持
Stud Health Technol Inform. 1995;16:105-13.
8
Act management and clinical guidelines.
Stud Health Technol Inform. 1995;16:117-24.
9
Standards of care in reproductive health services.生殖健康服务中的护理标准。
West J Med. 1995 Sep;163(3 Suppl):28-32.
10
Legal thoughts on the implications of cost-reducing guidelines for the quality of health care.
Health Policy. 2007 Mar;80(3):422-31. doi: 10.1016/j.healthpol.2006.05.003. Epub 2006 Jun 5.
引用本文的文献
1
Adaptation Frameworks for Clinical Guidelines and Proposing a Framework for Iran: A Review and Comparative Study.临床指南的适应框架及为伊朗提出一个框架：综述与比较研究
Med J Islam Repub Iran. 2022 Feb 16;36:10. doi: 10.47176/mjiri.36.10. eCollection 2022.
2
Implementing broad scale childhood immunization decision support as a web service.将大规模儿童免疫决策支持作为一种网络服务来实施。
AMIA Annu Symp Proc. 2009 Nov 14;2009:745-9.
3
4
The anatomy of decision support during inpatient care provider order entry (CPOE): empirical observations from a decade of CPOE experience at Vanderbilt.住院护理人员医嘱录入（CPOE）过程中的决策支持剖析：来自范德比尔特十年CPOE经验的实证观察
J Biomed Inform. 2005 Dec;38(6):469-85. doi: 10.1016/j.jbi.2005.08.009. Epub 2005 Oct 21.
5
Coupling computer-interpretable guidelines with a drug-database through a web-based system--The PRESGUID project.通过基于网络的系统将计算机可解释指南与药物数据库相结合——PRESGUID项目。
BMC Med Inform Decis Mak. 2004 Mar 2;4:2. doi: 10.1186/1472-6947-4-2.
6
PDAs in clinical practice: having a database in your hand but keeping the decision in your brain.
Neuroinformatics. 2003;1(2):207-9. doi: 10.1007/s12021-003-0007-9.
7
Effects of computerized guidelines for managing heart disease in primary care.初级保健中管理心脏病的计算机化指南的效果。
J Gen Intern Med. 2003 Dec;18(12):967-76. doi: 10.1111/j.1525-1497.2003.30635.x.
8
Automating complex guidelines for chronic disease: lessons learned.慢性病复杂指南的自动化：经验教训。
J Am Med Inform Assoc. 2003 Mar-Apr;10(2):154-65. doi: 10.1197/jamia.m1181.
9
10
Decision support and safety of clinical environments.临床环境中的决策支持与安全性。
Qual Saf Health Care. 2002 Mar;11(1):69-75. doi: 10.1136/qhc.11.1.69.
本文引用的文献
1
Physician inpatient order writing on microcomputer workstations. Effects on resource utilization.医生在微型计算机工作站上书写住院医嘱。对资源利用的影响。
JAMA. 1993 Jan 20;269(3):379-83.
2
Computerizing guidelines to improve care and patient outcomes: the example of heart failure.将指南计算机化以改善护理和患者预后：以心力衰竭为例。
J Am Med Inform Assoc. 1995 Sep-Oct;2(5):316-22. doi: 10.1136/jamia.1995.96073834.
3
Reminders to physicians from an introspective computer medical record. A two-year randomized trial.来自自省式计算机病历系统对医生的提醒。一项为期两年的随机试验。
Ann Intern Med. 1984 Jan;100(1):130-8. doi: 10.7326/0003-4819-100-1-130.
4
The impact of reading on physicians' nonadherence to recommended standards of medical care.阅读对医生不遵守推荐医疗标准的影响。
Soc Sci Med. 1985;21(8):909-14. doi: 10.1016/0277-9536(85)90147-9.
5
Computerized display of past test results. Effect on outpatient testing.过去检测结果的计算机化显示。对门诊检测的影响。
Ann Intern Med. 1987 Oct;107(4):569-74. doi: 10.7326/0003-4819-107-4-569.
6
Computer predictions of abnormal test results. Effects on outpatient testing.计算机对异常检测结果的预测。对门诊检测的影响。
JAMA. 1988 Feb 26;259(8):1194-8.
7
Using clinical data to predict abnormal serum electrolytes and blood cell profiles.
J Gen Intern Med. 1989 Sep-Oct;4(5):375-83. doi: 10.1007/BF02599685.
8
The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests.告知医生门诊诊断检查费用对检查医嘱的影响。
N Engl J Med. 1990 May 24;322(21):1499-504. doi: 10.1056/NEJM199005243222105.
9
10
Practice randomization and clinical research. The Indiana experience.
Med Care. 1991 Jul;29(7 Suppl):JS57-64.
Zotero 插件