Brigl B, Ringleb P, Steiner T, Knaup P, Hacke W, Haux R
Department of Medical Informatics, University of Heidelberg, Germany.
Methods Inf Med. 1998 Jan;37(1):16-25.
Today, the demand for medical decision support to improve the quality of patient care and to reduce costs in health services is generally recognized. Nevertheless, decision support is not yet established in daily routine within hospital information systems which often show a heterogeneous architecture but offer possibilities of interoperability. Currently, the integration of decision support functions into clinical workstations is the most promising way. Therefore, we first discuss aspects of integrating decision support into clinical workstations including clinical needs, integration of database and knowledge base, knowledge sharing and reuse and the role of standardized terminology. In addition, we draw up functional requirements to support the physician dealing with patient care, medical research and administrative tasks. As a consequence, we propose a general architecture of an integrated knowledge-based clinical workstation. Based on an example application we discuss our experiences concerning clinical applicability and relevance. We show that, although our approach promotes the integration of decision support into hospital information systems, the success of decision support depends above all on an adequate transformation of clinical needs.
如今，人们普遍认识到需要医疗决策支持来提高患者护理质量并降低医疗服务成本。然而，决策支持在医院信息系统的日常工作中尚未确立，医院信息系统通常架构异构，但具备互操作性。目前，将决策支持功能集成到临床工作站是最具前景的方式。因此，我们首先讨论将决策支持集成到临床工作站的各个方面，包括临床需求、数据库与知识库的集成、知识共享与重用以及标准化术语的作用。此外，我们制定功能需求以支持医生处理患者护理、医学研究和管理任务。在此基础上，我们提出一个基于知识的集成临床工作站的总体架构。基于一个示例应用，我们讨论了关于临床适用性和相关性的经验。我们表明，虽然我们的方法促进了决策支持与医院信息系统的集成，但决策支持的成功首先取决于临床需求的充分转化。
