Infobuttons to Improve Clinicians' Access to Information

描述（由申请人提供）： 在决策时无法及时获得信息是医疗差错的一个有据可查的近因。 我们假设，当使用临床信息系统（CIS），护士和医生遇到特定的信息需求，可以预测的基础上，他们正在审查的信息。 我们假设，提供旨在解决这些需求的在线资源的链接，可以降低信息搜索被推迟的速度，并增加信息搜索成功的速度。 我们将使用“信息按钮”来研究这个问题;这些程序使用特定于上下文的信息来预测信息需求，并自动从适当的资源中检索。 我们已经构建、测试和部署了信息按钮，并取得了积极的成果。 我们认为现在是时候通过以下方式正式研究它们：a）研究临床医生在CIS中查看数据时产生的信息需求; B）构建满足这些特定需求的信息按钮; c）开发一种机制，以支持独立于机构的信息按钮集成到CIS中; d）研究此类信息按钮一旦集成到工作CIS中，改善信息获取的能力。 我们将直接观察临床医生，一个不引人注目的“便携式可用性实验室”，因为他们使用基于Web的CIS在病人护理的常规过程。 我们将要求他们“大声思考”他们的信息需求，将他们的言行录下来。 我们将分析交互作用，以确定在给定的背景下，最有可能出现的信息需求。 然后，我们将构建信息按钮来自动检索与特定需求相关的特定信息。 信息按钮将被纳入信息系统，使用一个“信息按钮管理器”，该管理器将是自动化和数据驱动的，同时保持信息按钮独立于机构的性质。 然后，我们将研究临床医生对信息按钮的使用，以回答以下问题：1）当临床医生使用CIS时，会出现什么信息需求？ 2)是否可以建立独立于机构的信息按钮，以满足特定背景的需求？ 3)infobuttons是否改善了临床实践中的信息访问？

DESCRIPTION (provided by applicant): Inadequate access to timely information at the moment of decision-making is a well-documented proximal cause of medical errors. We hypothesize that when using a clinical information system (CIS), nurses and physicians encounter specific information needs that can be predicted, based on the information they are reviewing. We hypothesize that providing links to on-line resources designed to resolve those needs, can decrease the rate at which information seeking is deferred and increase the rate at which information seeking is successful. We will study this problem using "infobuttons"; programs that use context-specific information to anticipate information needs and automate retrieval from appropriate resources. We have built, tested and deployed infobuttons with positive anecdotal results. We believe it is now time to study them formally by: a) Studying information needs that arise when clinicians look at data in a CIS; b) Building infobuttons that address those specific needs; c) Develop a mechanism to support institution independent integration of infobuttons into a CIS and; d) Studying the ability of such infobuttons, once integrated into a working CIS, to improve access to information. We will directly observe clinicians, with an unobtrusive "portable usability laboratory", as they use a Web-based CIS in the routine course of patient care. We will ask them to "think aloud" about their information needs, capturing what they say and do on videotape. We will analyze the interactions to determine, for a given context, the information needs most likely to arise. We will then construct infobuttons to automate the retrieval of specific information relevant to specific needs. The infobuttons will be integrated into the CIS, using an "Infobutton Manager" that will be automated and data-driven while preserving the institution-independent nature of the infobuttons. We will then study clinicians' use of infobuttons to answer the following questions: 1) What information needs arise when clinicians use a CIS? 2) Can institution-independent infobuttons be built that address context-specific needs? 3) Do infobuttons improve access to information during clinical practice?