Open, interoperable, and configurable clinical decision support modules for OpenMRS, OpenEMR, and beyond

项目摘要 尽管临床决策支持系统（CDSS）可以是临床环境中的有效工具，但是这样的系统 如果没有最新的CDSS规则，则可能与当前的临床实践无关。管理和维护CDSS 规则可能是资源密集型的，即使对于通常拥有更多资源的大型学术医疗中心也是如此 小的医疗实践。我们的父项目R01（1R01GM138589）旨在利用语义Web 技术，使可重复使用和便携式CDSS规则，并使临床医生能够独立管理和 遵守CDSS规则。父R01项目的目标是使用OpenMRS和OpenEMR作为示例 以证明可行性。行政补充项目建议将内部守则改为 OpenMRS和OpenEMR的可分发模块。行政补充项目将受益 现有的OpenMRS和OpenEMR社区，即，临床医生和患者群体。主要交付成果 包括具有全面功能的可随时分发的CDSS模块， 更高质量的文档、说明和CDSS教育模块。在父R01项目中， 计划将必要的CDSS功能作为内部代码开发和测试， 文件或用户说明，也没有计划教育部分。 与此同时，我们将继续探索一种更通用的解决方案，以使临床医生受益， 病人加强临床护理服务。我们预期新加入的社区发展支援系统模块， 向两个系统服务的人群提供更加一致的预防服务。由于我们的努力， 模块的临床医生用户可以以自我维持的方式提供服务。 这两个新单元可用作CDSS的教学平台，向学生和学员介绍 CDSS的运行、配置、管理、 维护和监控。对于无法使用操作电子设备的医学和健康学生， 医疗记录（EMR）系统或CDSS，学生可以获得CDSS的经验，通过实践会议使用 这些模块。对于计算机科学专业的学生来说，这些模块可以帮助他们理解 在EMR环境下的临床护理。我们预计，教育模块将（1）准备未来的CDSS 用户和设计师更全面，（2）使他们能够优化CDSS，并最大限度地提高 CDSS的潜力，以及（3）更好地为未来的医疗保健IT人才做好准备。实际上，我们的新 拟议的项目将使现有和未来的OpenMRS和OpenEMR用户及其患者受益。这项工作 将帮助我们实现父R01项目的目标。通过联合国人权事务高级专员办事处的工作获得的经验 CDSS模块将帮助我们从概念上理解CDSS规则的互操作性， 互操作性的问题，并阐明了在更大范围内解决互操作性的未来方向。

Project summary Although a clinical decision support system (CDSS) can be an effective tool in clinical settings, such systems can be irrelevant to current clinical practice without up-to-date CDSS rules. Managing and maintaining CDSS rules can be resource-intensive, even for large academic medical centers, which typically have more resources than small medical practices. Our parent R01 project (1R01GM138589) aims to leverage Semantic Web technology to enable reusable and portable CDSS rules and enable clinicians to independently manage and maintain CDSS rules. The goal of the parent R01 project is to use the OpenMRS and OpenEMR as examples to demonstrate feasibility. The administrative supplement project proposes transforming internal codes into ready-to-distribute modules of OpenMRS and OpenEMR. The administrative supplement project will benefit existing OpenMRS and OpenEMR communities, i.e., clinicians and patient populations. The major deliverables of the administrative supplement include ready-to-distribute CDSS modules with comprehensive functionalities, higher-quality documentation, instructions, and CDSS educational modules. In the parent R01 project, the necessary CDSS functionalities were planned to be developed and tested as internal codes without documentation or user instructions, nor was the educational component planned. Meanwhile, we continue to explore a more generic solution to the issues that can benefit clinicians and patients by enhancing clinical care services. We anticipate that the newly added CDSS modules will facilitate more consistent preventive services to the populations served by both systems. Due to our efforts, the modules’ clinician users can provide services in a self-sustainable manner. The two new modules can be used as CDSS teaching platforms to educate students and trainees about the life cycle and technical mechanisms of CDSS regarding its operation, configuration, management, maintenance, and monitoring. For medical and health students without access to operational electronic medical records (EMR) systems or CDSS, students can obtain CDSS experience via hands-on sessions using these modules. For computer science students, these modules can facilitate understanding of basic terms of clinical care within EMR contexts. We anticipate that the educational modules will (1) prepare future CDSS users and designers more comprehensively, (2) empower them to optimize the CDSS and maximize the full potential of CDSS, and (3) better prepare the future workforce for healthcare IT. In practical terms, our newly proposed project will benefit existing and future OpenMRS and OpenEMR users and their patients. This work will help us achieve our goal for the parent R01 project. The experience obtained through the work of the CDSS modules will help us understand the interoperability of CDSS rules conceptually, pinpoint the underlying issues of interoperability, and shed light on future directions in tackling interoperability on a larger scale.