Enabling Psychiatrists' Access to Knowledge Resources

描述(由申请人提供)：这项资助申请建议在护理地点向精神健康专业人员提供基于网络的在线信息和知识资源，这些资源包括电子文档和文本、数据库、搜索引擎、指南和任何与患者护理决策过程相关的参考材料。近年来，医疗差错激增的现象得到了很好的宣传。尽管精神病学中关于不良事件的数据不太完整，但有许多研究记录了临床实践偏离可接受标准的方式。对及时信息的获取常常被认为是导致错误和不合格做法的直接原因。美国精神病学协会、认证机构和附属精神卫生组织最近为促进精神卫生专业中的循证医学而采取的举措，提供了前所未有且迅速增长的在线资源池，如医生和护士的临床实践指南。我们建议将信息按钮管理器技术与现有的电子病历系统--精神健康自动检索系统(MHARS)--集成。信息按钮是一种资源传递系统，已在哥伦比亚大学的临床信息系统中实施。它的工作原理是在EMR中创建链接，将临床医生的上下文传递给将上下文与信息需求相匹配的应用程序，为该需求选择资源，制定对该资源的查询，将查询传递给资源，并将结果显示给临床医生。这一行动的结果是在临床医生的桌面上打开一个浏览器窗口，以查询的形式链接到上下文敏感的Medline搜索、指南和其他相关文件。具体目标是： (1)为精神卫生专业人员提供在护理地点实时获取指南和其他资源的机会。(2)使信息资源提供系统适用于精神卫生领域，最初的重点是特定的药理学领域。(3)与新实施的电子病历系统--精神健康自动检索系统(MHARS)--配合使用InfoButton Manager应用程序。(4)在4个有代表性的机构实施InfoButton，由精神健康办公室服务的患者群体包括：成人、儿童、法医和研究机构。

DESCRIPTION (provided by applicant): This grant application proposes to provide web-based on-line information and knowledge resources to mental health professionals at the point of care, These resources include electronic documents and texts, databases, search engines, guidelines and any reference materials that are relevant to the decision-making process in patient care. The proliferation of errors in medical practice has been well publicized in recent years. Although the data on adverse events in psychiatry is less complete, there are numerous studies documenting the ways in which clinical practice deviates from acceptable standards. Access to timely information is often cited as on the proximal causes of error and substandard practices. Recent initiatives taken by the American Psychiatric Association, accrediting bodies, and affiliated mental health organizations to promote evidence-based medicine in the mental health profession have made available an unprecedented and rapidly growing pool of on-line resources such as clinical practice guidelines for physicians and nurses. We propose to integrate lnfobuttons manager technology with an existing electronic medical record system, Mental Health Automated Retrieval System (MHARS). lnfobuttons is a resource delivery system that has been implemented in clinical information systems at Columbia. It works by creating links within the EMR that passes the clinician's context to an application that matches the context to an information need, selects a resource for that need, formulates a query to that resource, passing the query to the resource, and displaying the results to the clinician. The result of the action is to open a browser window on the clinician's desktop with links in the forms of queries to context-sensitive Medline searches, guidelines and other pertinent documents. The specific aims are: (1) Provide mental health professionals with access to guidelines and other resources in real time at point of care. (2) Adapt the lnfobuttons information resource delivery system to the field of mental health with an initial focus in the specific area of pharmacology. (3) Employ lnfobuttons Manager application in concert with the newly implemented electronic medical record system, Mental Health Automatic Retrieval System (MHARs) (4) Implement lnfobuttons in 4 representative institutions by the patient population served by the Office of Mental Health including: adult, child, forensic, and research institutions.