Int J Med Inform - A comparative review of patient safety initiatives for national health information technology.

Tópicos

{ implement(1333) system(1263) develop(1122) }
{ patient(2315) diseas(1263) diabet(1191) }
{ monitor(1329) mobil(1314) devic(1160) }
{ health(3367) inform(1360) care(1135) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ case(1353) use(1143) diagnosi(1136) }
{ framework(1458) process(801) describ(734) }
{ clinic(1479) use(1117) guidelin(835) }
{ compound(1573) activ(1297) structur(1058) }
{ ehr(2073) health(1662) electron(1139) }
{ inform(2794) health(2639) internet(1427) }
{ treatment(1704) effect(941) patient(846) }
{ concept(1167) ontolog(924) domain(897) }
{ extract(1171) text(1153) clinic(932) }
{ medic(1828) order(1363) alert(1069) }
{ use(976) code(926) identifi(902) }
{ decis(3086) make(1611) patient(1517) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ featur(1941) imag(1645) propos(1176) }
{ howev(809) still(633) remain(590) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ state(1844) use(1261) util(961) }
{ first(2504) two(1366) second(1323) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ bind(1733) structur(1185) ligand(1036) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ error(1145) method(1030) estim(1020) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ model(2220) cell(1177) simul(1124) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ blood(1257) pressur(1144) flow(957) }
{ patient(2837) hospit(1953) medic(668) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ intervent(3218) particip(2042) group(1664) }
{ use(2086) technolog(871) perceiv(783) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ problem(2511) optim(1539) algorithm(950) }
{ algorithm(1844) comput(1787) effici(935) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ care(1570) inform(1187) nurs(1089) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ data(3963) clinic(1234) research(1004) }
{ perform(999) metric(946) measur(919) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ model(3480) simul(1196) paramet(876) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ 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) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: To collect and critically review patient safety initiatives for health information technology (HIT).METHOD: Publicly promulgated set of advisories, recommendations, guidelines, or standards potentially addressing safe system design, build, implementation or use were identified by searching the websites of regional and national agencies and programmes in a non-exhaustive set of exemplar countries including England, Denmark, the Netherlands, the USA, Canada and Australia. Initiatives were categorised by type and software systems covered.RESULTS: We found 27 patient safety initiatives for HIT predominantly dealing with software systems for health professionals. Three initiatives addressed consumer systems. Seven of the initiatives specifically dealt with software for diagnosis and treatment, which are regulated as medical devices in England, Denmark and Canada. Four initiatives dealt with blood bank and image management software which is regulated in the USA. Of the 16 initiatives directed at unregulated software, 11 were aimed at increasing standardisation using guidelines and standards for safe system design, build, implementation and use. Three initiatives for unregulated software were aimed at certification in the USA, Canada and Australia. Safety is addressed alongside interoperability in the Australian certification programme but it is not explicitly addressed in the US and Canadian programmes, though conformance with specific functionality, interoperability, security and privacy requirements may lead to safer systems. England appears to have the most comprehensive safety management programme for unregulated software, incorporating safety assurance at a local healthcare organisation level based on standards for risk management and user interface design, with national incident monitoring and a response function.CONCLUSIONS: There are significant gaps in the safety initiatives for HIT systems. Current initiatives are largely focussed on software. With the exception of diagnostic, prognostic, monitoring and treatment software, which are subject to medical device regulations in some countries, the safety of the most common types of HIT systems such as EHRs and CPOE without decision support is not being explicitly addressed in most nations. Appropriate mechanisms for safety assurance are required for the full range of HIT systems for health professionals and consumers including all software and hardware throughout the system lifecycle. In addition to greater standardisation and oversight to ensure safe system design and build, appropriate implementation and use of HIT is critical to ensure patient safety.

Resumo Limpo

jectiv collect critic review patient safeti initi health inform technolog hitmethod public promulg set advisori recommend guidelin standard potenti address safe system design build implement use identifi search websit region nation agenc programm nonexhaust set exemplar countri includ england denmark netherland usa canada australia initi categoris type softwar system coveredresult found patient safeti initi hit predomin deal softwar system health profession three initi address consum system seven initi specif dealt softwar diagnosi treatment regul medic devic england denmark canada four initi dealt blood bank imag manag softwar regul usa initi direct unregul softwar aim increas standardis use guidelin standard safe system design build implement use three initi unregul softwar aim certif usa canada australia safeti address alongsid interoper australian certif programm explicit address us canadian programm though conform specif function interoper secur privaci requir may lead safer system england appear comprehens safeti manag programm unregul softwar incorpor safeti assur local healthcar organis level base standard risk manag user interfac design nation incid monitor respons functionconclus signific gap safeti initi hit system current initi larg focuss softwar except diagnost prognost monitor treatment softwar subject medic devic regul countri safeti common type hit system ehr cpoe without decis support explicit address nation appropri mechan safeti assur requir full rang hit system health profession consum includ softwar hardwar throughout system lifecycl addit greater standardis oversight ensur safe system design build appropri implement use hit critic ensur patient safeti

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