Translating Hypertension Guidelines into Practice: Development of Interoperable Clinical Decision Support

项目摘要 尽管电子健康记录(EHR)几乎被普遍采用，但导致 提供临床数据以改善护理，但如何最好地利用医疗信息技术促进临床仍然是一个挑战 决策支持(CDS)。在这份提案中，我们将使用高血压新技术来定制， 跨设置和实施提供有用的CDS。我们将使用临床质量语言(CQL)， 新的健康七级国际标准，侧重于表达的通用模型 临床决策支持逻辑(CDS)和快速医疗保健可互操作资源(FHIR)标准， 演示如何减轻跨站点实施CDS规则的负担。 根据五权框架，实施良好的CDS旨在将正确的信息传递给正确的人 人员，使用正确的格式，在正确的渠道，在正确的时间在工作流程中。这项拨款建议 通过创建以患者为中心、可互操作、可共享的CDS工具来增强我们定制CDS的能力 提供者和患者根据他们的解释做出以患者为中心的临床行动决定 实践中相互矛盾的指导方针的变化。接下来，利用前面的工作，我们将建立临床决策 使用AHRQ CDS创作工具支持组件，并构建一个FHIR应用程序 为患者和医疗团队提供指导，对照患者数据库进行验证 高血压。最后，我们将与适当的患者和医疗团队一起评估这一应用程序，以了解 它在协助量身定做的决策、改进方法和传播方面的潜在影响。我们会 向公众传播这项研究中的所有要素，并衡量它们被使用和适应的频率。

Project Summary Despite near universal adoption of Electronic Health Records (EHRs), resulting in increasing amount of clinical data available to improve care, challenges remain about how to best leverage Health IT for Clinical Decision Support (CDS). In this proposal, we will use hypertension to use new technologies to make tailored, useful CDS available across settings and implementations. We will use Clinical Quality Language (CQL), a new Health Level Seven International Standard that focuses on a common model for representing expression logic for Clinical Decision Support (CDS), and the Fast Healthcare Interoperable Resources (FHIR) standard, to demonstrate how one can reduce the burden of implementing CDS rules across sites. Per the 5 Rights framework, well-implemented CDS aims to deliver the right information, to the right person, using the right format, in the right channel, and at the right time during workflow. This grant proposes to enhance our ability to tailor CDS by creating patient-centered, interoperable, sharable CDS tools by allowing providers and patients to make patient-centered decisions about clinical actions based on how they interpret variation in conflicting guidelines in practice. Next, leveraging previous work, we will build clinical decision support components using the AHRQ CDS Authoring tool and build a FHIR application that can elicit and provide guidance to both patients and health care teams, validating against a database of patients with hypertension. Finally, we will evaluate this application with appropriate patients and health care teams to learn its potential impact in assisting in tailored decision making, refining the approach and disseminating. We'll disseminate all of the elements in this study to the public and measure how often they are used and adapted.