Context-Aware Knowledge Delivery into Electronic Health Records

将情境感知知识传递到电子健康记录中

• 批准号: 8286769
• 负责人: GUILHERME DEL FIOL
• 金额: $ 13.98万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8286769
• 关键词: Context; Aware; Knowledge; Delivery; into

DESCRIPTION (provided by the applicant): This four-year project seeks to equip a clinician-scientist with a significant expertise in knowledge management (KM) and clinical decision support (CDS) with training and mentoring in health services research. This proposal aims at preparing the applicant to pursue a career as an independent investigator developing and evaluating KM and CDS interventions aimed at improving the quality, safety, efficiency, and effectiveness of health care in the U.S. and abroad. The candidate is an Assistant Professor of clinical informatics at Duke University with an M.D. degree and a Ph.D. in biomedical informatics. The candidate is the architect of a corporate-wide clinical knowledge delivery infrastructure and the author of an international knowledge delivery standard. The candidate will be mentored by a group of established investigators headed by Dr. Eric Peterson, the Director of Cardiovascular Research at the Duke Clinical Research Institute. The training and research will leverage unique scientific and training resources available at Duke University. As the primary component of his career development activities, the candidate will pursue a mentored research project focused on the development, implementation, and evaluation of a prototype for a scalable and replicable knowledge delivery system. The candidate will also pursue formal training, particularly in health services research; develop expertise in health IT standards relevant to KM and CDS; and prepare manuscripts and grant applications. The goal of the proposed research is to develop, implement, and evaluate a prototype for a scalable and widely deployable knowledge delivery service ("knowledge broker") capable of automatically delivering context-specific knowledge from online resources into electronic health record (EHR) and personal health record (PHR) systems via a "knowledge dashboard." The research will be conducted in accordance with three specific aims: (i) to build a knowledge base of patients' and providers' knowledge needs; (ii) to design, develop, and evaluate the usability of a scalable, widely deployable knowledge delivery service in a laboratory setting; (iii) To conduct a mixed-method assessment of a pilot implementation of the knowledge broker in a real-world Medical Home environment. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. In addition, the proposed software component is aligned with the development of an international standard within HL7 to support the integration between knowledge resources into EHR and PHR systems. Thus, if successful, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. This project seeks to support health care decision making and patient-centered care by delivering relevant, context-specific knowledge to patients and providers. The proposed system will be developed in conjunction with an emerging international standard on the integration between online knowledge resources and electronic health records. Thus, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale and play a significant role in the overall improvement of public health.

描述（由申请人提供）：这个为期四年的项目旨在为临床医生和科学家提供知识管理和临床决策支持方面的重要专业知识，并在卫生服务研究方面提供培训和指导。该提案旨在为申请人从事独立研究者的职业做好准备，以开发和评估KM和CDS干预措施，旨在提高美国和国外医疗保健的质量、安全性、效率和有效性。该候选人是杜克大学临床信息学助理教授，拥有医学博士学位和生物医学信息学博士学位。候选人是公司范围内临床知识传递基础设施的架构师和国际知识传递标准的作者。候选人将接受由杜克临床研究所心血管研究主任Eric Peterson博士领导的一组知名研究人员的指导。培训和研究将利用杜克大学独特的科学和培训资源。作为其职业发展活动的主要组成部分，候选人将从事一个有指导的研究项目，重点是开发、实施和评估一个可扩展和可复制的知识传递系统的原型。候选人还将接受正式培训，特别是卫生服务研究方面的培训；发展与知识管理和CDS相关的卫生信息技术标准方面的专业知识；准备稿件和拨款申请。拟议研究的目标是开发、实施和评估可扩展和广泛部署的知识交付服务（“知识代理”）的原型，该服务能够通过“知识仪表板”将特定于上下文的知识从在线资源自动交付到电子健康记录（EHR）和个人健康记录（PHR）系统中。这项研究有三个具体目的：(i)建立病人及医护人员知识需求的知识库；（ii）在实验室环境中设计、开发和评估可扩展、可广泛部署的知识传递服务的可用性；㈢对在真实医疗之家环境中试点实施知识中介的情况进行混合方法评估。拟议的研究解决了一个尚未解决的重大问题，即在护理过程中提出了很大比例的知识需求，但没有得到满足，这可能导致医疗差错，损害护理的安全和质量。此外，建议的软件组件与HL7内国际标准的开发保持一致，以支持将知识资源集成到EHR和PHR系统中。因此，如果成功的话，拟议的研究将为一种提供特定环境知识的方法提供一个原型，这种方法有可能在全国范围内复制。拟议的研究解决了一个尚未解决的重大问题，即在护理过程中提出了很大比例的知识需求，但没有得到满足，这可能导致医疗差错，损害护理的安全和质量。该项目旨在通过向患者和提供者提供相关的、具体情况的知识，支持医疗保健决策和以患者为中心的护理。拟议的系统将与一项关于在线知识资源和电子健康记录之间整合的新兴国际标准一起开发。因此，拟议的研究将提供一种提供具体情况知识的方法的原型，这种知识有可能在全国范围内复制，并在全面改善公共卫生方面发挥重要作用。

项目成果

Implementations of the HL7 Context-Aware Knowledge Retrieval ("Infobutton") Standard: challenges, strengths, limitations, and uptake.

• DOI: 10.1016/j.jbi.2011.12.006
• 发表时间: 2012-08
• 期刊: JOURNAL OF BIOMEDICAL INFORMATICS
• 影响因子: 4.5
• 作者: Del Fiol, Guilherme;Huser, Vojtech;Strasberg, Howard R.;Maviglia, Saverio M.;Curtis, Clayton;Cimino, James J.
• 通讯作者: Cimino, James J.

Meeting the electronic health record "meaningful use" criterion for the HL7 infobutton standard using OpenInfobutton and the Librarian Infobutton Tailoring Environment (LITE).

使用 OpenInfobutton 和 Librarian Infobutton Tailoring Environment (LITE) 满足 HL7 infobutton 标准的电子健康记录“有意义的使用”标准。

• 发表时间: 2012
• 期刊: AMIA ... Annual Symposium proceedings. AMIA Symposium
• 作者: Cimino,JamesJ;Jing,Xia;DelFiol,Guilherme
• 通讯作者: DelFiol,Guilherme