PATIENT CARE PROVIDER ORDER ENTRY WITH TACTICAL SUPPORT

描述(摘自项目摘要)：韦伯斯特的第三条新闻 国际词典(未删节)(Merriam-Webster，Inc.，Springfield Ma，1986)将战术定义为：使用可用的艺术或技能 有目共睹的力量“。通过集中注意力的机制 由直接医疗保健提供者订单录入提供，患者护理 将开发具有战术支持的提供商订单录入(PC-POETS)项目 利用以患者为中心的决策支持能力的策略 合乎逻辑、直截了当、高效。PC的中心主题--诗人 项目是患者护理提供者将他们的决定转化为行动 在写订单时，因此提供决策支持的干预是 通过订单录入系统以最佳方式实施。该项目将 完成Vanderbilt已经在进行的基于PC的 与患者护理提供者订单录入系统的接口，该系统将用作 提供决策支持能力的平台。 该项目将检验一个基本的和长期坚持的原则在医疗 信息学：“好的咨询师不缺客户”(莎士比亚，衡量 措施)-即医疗决策支持系统将获得广泛的 当功能的临界量通过 公共平台和接口。PC的子组件--POETS系统相关 决策支持能力包括：(A)自动或半自动 关于患者用药的药理学建议：药物专著， 过敏警报、药物-药物相互作用、费用指数，(B)自动或 半自动链接到有关患者诊断和治疗的文献 治疗性干预：基于UMLS的相关索引和检索 引文和摘要，自动或半自动链接到QMR 诊断决策支持知识库，(D)审查能力 指定订单(实验室、药房、放射学)的费用/成本 (E)针对特定患者的提醒；(F)抗生素 订购工具，以帮助建议具有成本效益的方案；(G)自动或 半自动比较过去或当前建议的订单与 订单的具体时间表(“临床路径”)，提供了对 相似之处和不同之处，(H)患者状态摘要工具，用于审查 患者状态在短时间间隔内的显著变化，例如 12到72小时。该职能将审查实验室和其他数据 在火星系统中可用来回答这个问题，“发生了什么事 患者在过去12-72小时内？“，(I)形成性评估 项目的前18个月，以及(J)一项随机对照试验 在最后18个月的临床环境中评估PC-POET 建议的项目。

DESCRIPTION (Taken from project abstract): Webster's Third New International Dictionary (unabridged) (Merriam-Webster, Inc., Springfield MA, 1986) defines tactics as: "the art or skill of employing available forces with an end in view". Through the attention-focusing mechanism provided by direct health-care provider order entry, the Patient Care Provider Order Entry with Tactical Support (PC-POETS) project will develop tactics that make the use of patient-centered decision support capabilities logical, straightforward, and efficient. The central theme of the PC-POETS project is that patient care providers convert their decisions into actions at the time of order-writing, so intervention to provide decision support is implemented optimally through an order entry system. The project will complete the development, already under way at Vanderbilt, of a PC-based interface to a patient care provider order entry system, which will serve as the platform for delivering decision support capabilities. The project will test a fundamental and long-held tenet in medical informatics: "Good counselors lack no clients" (Shakespeare, Measure for Measure) - i.e., that medical decision support systems will gain widespread acceptance when a critical mass of functionality is made available through a common platform and interface. Subcomponents of the PC-POETS system related to decision support capabilities include: (a) automated or semi-automated pharmacological advice regarding a patient's medications: drug monographs, allergy alerts, drug-drug interactions, index of expenses, (b) automated or semi-automated links to the literature regarding a patients diagnoses and therapeutic interventions: UMLS-based indexing and retrieval of relevant citations and abstracts, automated or semi-automated linkages to the QMR Knowledge Base for diagnostic decision support, (d) ability to review charges/costs for given orders (lab, pharmacy, radiology) on a patient-specific basis, (e) patient-specific reminders, (f) an antibiotic ordering tool to help suggest cost-effective regimens, (g) automated or semi-automated comparison of past or currently proposed orders to a specified schedule of orders ("clinical pathway"), providing a critique of similarities and differences, (h) a patient status summary tool that reviews significant changes in a patients status over a short time interval, such as 12 to 72 hours. The function will review laboratory and other data available in the MARS system to answer the question, "What happened to the patient during the last 12-72 hours?", (I) formative evaluation during the first 18 months of the project, and (j) a randomized controlled trial to evaluate PC-POETS in the clinical setting during the final 18 months of the proposed project.