SHARED INTERNET SERVER FOR DELIVERING GUIDELINES

描述(摘自申请摘要)：医疗保健的最新趋势 交付工作使人们更加重视制定指导方针 用于预防、诊断检查、治疗和患者管理流程 (临床路径)。这样的指导方针是出于对标记的担忧 临床实践中的各种变化，旨在帮助提供共同的 卫生保健组织内部和不同组织之间的护理标准 组织。拟议研究的目标是开发工具和 通过开发一种技术来促进指南的计算机化 代表它们的标准，存储和执行它们的互联网服务器， 转换到本地执行环境的机制，并最终使用 与基于计算机的医疗记录系统相结合。 这项提案包括来自五个学术医学中心和 美国医师学会(ACP)建立并测试这些 创建、分发和使用临床指南的方法。 我们将共同努力，实现以下五个具体目标： 1)创建指南服务器(可通过Internet访问)，该指南服务器可以 为分发和共享指南的编码版本提供支持 B)、AHCPR等联邦机构和医疗组织 例如机场核心计划。服务器将允许访问者执行五项活动： A)使用指南的网络版本浏览编码指南 创建和查看工具；b)访问的原始文本版本 关于预期范围的假设的文件和描述 准则；c)要求基于服务器的资格计算 准则和某些类别协议的执行；d)下载 Glif格式的指南说明，适用于本地定制和 执行；以及e)要求提供关于其他个人的信息或 使用相同准则的组织； 2)检查、描述和编码每个具有代表性的指导方针 这四个地点。对于我们的试验台，我们将使用ACP开发的子集 由其他联邦或医疗机构创建的指南补充的指南 组织； 3)继续我们目前的研究工作，以代表 支持施舍I和施舍2的准则； 4)在哥伦比亚和马萨诸塞州综合医院实施指导方针 医院，在每个组织获得适当的机构后 临床使用的批准，并评估指南在这些 两个临床地点；以及 5)研究创建指导方针的认知方面，编码任务 以及计算机辅助的指南的临床应用 环境。

DESCRIPTION (Taken from application abstract): Recent trends in health care delivery have led to an increased emphasis on the development of guidelines for prevention, diagnostic workup, treatment, and patient-management processes (clinical pathways). Such guidelines are motivated by concerns about marked variations in clinical practice and are designed to help provide a common standard of care both within a health care organization and among different organizations. The goal of the proposed research is to develop tools and techniques to promote the computerization of guidelines by developing a standard to represent them, an Internet server to store and execute them, mechanisms for translation into a local execution environment, and finally use in conjunction with computer-based medical record systems. This proposal includes researchers from five academic medical centers and the American College of Physicians (ACP) to build and test the generality of these approaches to the creation, distribution, and use of clinical guidelines. Together, we will pursue the following five specific aims: 1) To create a guideline server (accessible over the Internet) that can provide support for distributing and sharing encoded versions of guidelines developed b), federal agencies such as the AHCPR and medical organizations such as the ACP. The server will allow visitors to perform five activities: a) to browse the encoded guidelines using a web-based version of the guideline creation and viewing tools; b) to access both the original textual versions of the documents and descriptions of assumptions about the intended scope of the guidelines; c) to request server-based computation of eligibility for guidelines and execution of some categories of protocols; d) to download guideline descriptions in GLIF format for local custom tailoring and implementation; and e) to request information about other individuals or organizations which are utilizing the same guidelines; 2) To examine, characterize, and encode representative guidelines at each of the four sites. For our testbed, we will use a subset of the ACP-developed guidelines augmented by guidelines created by other federal or medical organizations; 3) To continue our current research efforts in the representation of guidelines to support alms I and 2; 4) To put the guidelines into operation at Columbia and Massachusetts General Hospital, after each organization has obtained the appropriate institutional approvals for clinical use and to assess how the guidelines are used at these two clinical sites; and 5) To study cognitive aspects of creating guidelines, of the encoding tasks described above, and of the clinical use of guidelines in computer assisted environments.