A highly scalable, interoperable clinical decision support service
A highly scalable, interoperable clinical decision support service
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DOI：
10.1136/amiajnl-2013-001990
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发表时间：
2014-02-01
影响因子：
6.4
通讯作者：
Middleton, Blackford
中科院分区：
文献类型：
--
作者：
Goldberg, Howard S.;Paterno, Marilyn D.;Middleton, Blackford
目的建立一个临床决策支持（CDS）系统，该系统可在大的地理区域的医疗服务系统和设置中共享。材料和方法企业临床规则服务（ECRS）通过一系列企业Java Bean实现了9个设计原则，并利用现成的规则管理系统，以便提供一致的、可维护的、可扩展的、结果ECRS部署在合作伙伴医疗保健系统（PHS），并用于CDS联盟成员的一系列试验，包括PHS，Regenstrief研究所，以及部署在俄勒冈州和新泽西的基于供应商的系统。性能指标表明，ECRS提供了次秒级的响应时间时，测量除了所需的服务，检索数据和组装的连续性护理文件用作input.Discussion我们认为相关的工作，设计决策，比较与新兴的国家标准，并讨论使用和限制的ECRS。结论ECRS的设计，实施，和CDS财团试验中的使用表明，它提供了广泛使用所需的灵活性和模块化，并充分发挥作用。未来的工作将研究更多的CDS模式，数据传递的替代方法，以及ECRS性能的进一步优化。
Objective To create a clinical decision support (CDS) system that is shareable across healthcare delivery systems and settings over large geographic regions.Materials and methods The enterprise clinical rules service (ECRS) realizes nine design principles through a series of enterprise java beans and leverages off-the-shelf rules management systems in order to provide consistent, maintainable, and scalable decision support in a variety of settings.Results The ECRS is deployed at Partners HealthCare System (PHS) and is in use for a series of trials by members of the CDS consortium, including internally developed systems at PHS, the Regenstrief Institute, and vendor-based systems deployed at locations in Oregon and New Jersey. Performance measures indicate that the ECRS provides sub-second response time when measured apart from services required to retrieve data and assemble the continuity of care document used as input.Discussion We consider related work, design decisions, comparisons with emerging national standards, and discuss uses and limitations of the ECRS.Conclusions ECRS design, implementation, and use in CDS consortium trials indicate that it provides the flexibility and modularity needed for broad use and performs adequately. Future work will investigate additional CDS patterns, alternative methods of data passing, and further optimizations in ECRS performance.