Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts
Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts
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DOI：
10.1136/amiajnl-2012-000887
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发表时间：
2013-01-01
影响因子：
6.4
通讯作者：
Middleton, Blackford
中科院分区：
文献类型：
--
作者：
Kawamoto, Kensaku;Hongsermeier, Tonya;Middleton, Blackford
目的 确定建立国家临床决策支持 (CDS) 知识共享框架的关键原则。 材料和方法 作为美国国家卫生信息技术协调员办公室 (ONC) 建立国家 CDS 知识共享框架倡议的一部分，确定了主要利益相关者。通过调查和深度访谈获取利益相关者的观点，并总结调查结果和相关见解。基于这些见解，制定了建立国家 CDS 知识共享框架的关键原则。 结果 招募了 19 名关键利益相关者，包括来自电子健康记录系统供应商的 6 名高管、来自知识内容生产者的 7 名高管、来自医疗保健提供者组织的 3 名高管以及另外 3 名临床信息学专家。根据这些利益相关者的见解，确定了在全国范围内有效共享 CDS 知识的五项关键原则。这些原则是 (1) 优先考虑并支持国家 CDS 知识共享框架的创建和维护； (2) 促进高价值内容和工具的开发，最好以开源方式进行； (3) 加速制定或许可所需的、实用的标准； (4) 承认并解决医疗法律责任问题； (5) 建立自我维持的商业模式。 讨论 根据确定的原则，通过 ONC 推进 CDS 计划制定了国家 CDS 知识共享路线图。结论 该研究结果可以为 ONC 和其他机构正在进行的活动提供有用的指导，以建立共享 CDS 知识和改善临床护理的国家框架。
Objective To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework.Materials and methods As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework.Results Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model.Discussion Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative.Conclusion The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care.