J Am Med Inform Assoc - Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems.

Tópicos

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{ framework(1458) process(801) describ(734) }
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{ model(2656) set(1616) predict(1553) }
{ use(1733) differ(960) four(931) }
{ design(1359) user(1324) use(1319) }
{ medic(1828) order(1363) alert(1069) }
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{ care(1570) inform(1187) nurs(1089) }
{ record(1888) medic(1808) patient(1693) }
{ data(3008) multipl(1320) sourc(1022) }
{ analysi(2126) use(1163) compon(1037) }
{ cancer(2502) breast(956) screen(824) }
{ studi(2440) review(1878) systemat(933) }
{ clinic(1479) use(1117) guidelin(835) }
{ spatial(1525) area(1432) region(1030) }
{ state(1844) use(1261) util(961) }
{ gene(2352) biolog(1181) express(1162) }
{ imag(1947) propos(1133) code(1026) }
{ sequenc(1873) structur(1644) protein(1328) }
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{ patient(2837) hospit(1953) medic(668) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
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{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways.METHODS: A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation 'challenge' themes.RESULTS: One hundred and eight relevant studies were selected for review. Twenty-five underlying 'challenge' themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed.DISCUSSION AND CONCLUSION: We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings.

Resumo Limpo

jectiv need integr various theoret framework formal model clinic guidelin workflow pathway order move beyond provid support individu clinic decis toward provis processori patientcent health inform system review analyz challeng develop processori formal model guidelin workflow care pathwaysmethod qualit metasynthesi perform studi publish english address model process report exposit new methodolog model system implement system architectur themat analysi princip compon analysi pca data visualis techniqu use identifi cluster under implement challeng themesresult one hundr eight relev studi select review twentyf under challeng theme identifi cluster distinct group conceptu model implement process developeddiscuss conclus found develop system support individu clinic decis evolv toward implement adapt care pathway semant web incorpor formal clinic organiz ontolog use workflow manag system architectur now need implement evalu wider scale within clinic set

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