Evidence-based design of an XML decision support system

描述(由申请人提供)： 最近完成的一项系统回顾确定了临床决策支持系统(CDSS)的特定功能，这些功能对于实现期望的临床实践模式变化最重要。拟议研究的目标是应用从这项系统审查中获得的见解来设计基于XML的CDSS，并使用该CDSS来改善居住在北卡罗来纳州中部的大约13,000名医疗补助受益者的护理。CDSS将支持遵守HEDIS的预防和慢性护理指南，并将向包括临床医生、社会工作者、护理经理和患者在内的各种利益攸关方提供决策支持通信。值得注意的是，这项工作将利用该小组建立的一些现有资源，包括基于XML的核心决策支持引擎、旨在支持医疗补助患者护理的临床数据库，以及用于直接从患者那里收集信息的触摸屏系统。在建立CDSS时，将使用系统分析技术为设计过程提供信息，并将使用快速原型方法进行系统开发。然后，将进行随机对照试验来评估CDSS的影响，并使用为其提供决策支持的HEDIS指标来衡量结果。

DESCRIPTION (provided by applicant): A recently completed systematic review identified the specific features of clinical decision support systems (CDSSs) that are most important for bringing about a desired change in clinical practice patterns. The objective of the proposed research is to apply the insights gained from this systematic review to design an XML-based CDSS, and to use this CDSS to improve the care of approximately 13,000 Medicaid benificiaries living in central North Carolina. The CDSS will support compliance with HEDIS guidelines for preventive and chronic care, and decision support communications will be provided to a variety of stakeholders, including clinicians, social workers, care managers, and patients. Of note, this work will leverage a number of existing resources established by this group, including a core XML-based decision support engine, a clinical database designed to support the care of Medicaid patients, and a touch-screen system for collecting information directly from patients. In building the CDSS, systems analysis techniques will be used to inform the design process, and a rapid prototyping approach will be used for system development. Then, a randomized controlled trial will be conducted to evaluate the impact of the CDSS, and outcomes will be measured using the HEDIS indicators for which the decision support was provided.