A design model for computer-based guideline implementation based on information management services
A design model for computer-based guideline implementation based on information management services
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DOI：
10.1136/jamia.1999.0060099
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发表时间：
1999-03-01
影响因子：
6.4
通讯作者：
Corb, GJ
中科院分区：
文献类型：
--
作者：
Shiffman, RN;Brandt, CA;Corb, GJ
临床实践指南如果要影响临床医生的行为，就必须得到有效实施。作者描述了一种基于计算机的指南实施模型，该模型确定了将基于指南的决策支持与临床工作流程相结合所需的八种信息管理服务。推荐服务确定在特定临床情况下的适当活动。文件服务涉及数据采集。登记服务整合了人口和行政数据。解释服务通过提供支持性证据和对证据质量进行评级来增强自动化建议的可信度。计算服务测量时间间隔，建议药物剂量，并执行其他计算任务。通信服务采用信息传输标准并提供数据安全性。有效的演示服务有助于理解复杂的数据，澄清趋势，并为患者格式化书面材料（包括处方）。聚合服务将结果与特定的指导方针干预相关联。作者提供了由美国儿科学会开发的五个循证实践参数组成模型的八项服务的例子。
clinical practice guidelines must be implemented effectively if they are to influence the behavior of clinicians. The authors describe a model for computer-based guideline implementation that identifies eight information management services needed to integrate guideline-based decision support with clinical workflow. Recommendation services determine appropriate activities in specific clinical circumstances. Documentation services involve data capture. Registration services integrate demographic and administrative data. Explanation services enhance the credibility of automated recommendations by providing supportive evidence and rating the quality of evidence. Calculation services measure time intervals, suggest medication dosages, and perform other computational tasks. Communication services employ standards for information transfer and provide data security. Effective presentation services facilitate understanding of complex data, clarify trends, and format written materials (including prescriptions) for patients. Aggregation services associate outcomes with specific guideline interventions. The authors provide examples of the eight services that make up the model from five evidence-based practice parameters developed by the American Academy of Pediatrics.