J Am Med Inform Assoc - A clinical decision support needs assessment of community-based physicians.

Tópicos

{ care(1570) inform(1187) nurs(1089) }
{ decis(3086) make(1611) patient(1517) }
{ design(1359) user(1324) use(1319) }
{ ehr(2073) health(1662) electron(1139) }
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{ gene(2352) biolog(1181) express(1162) }
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{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
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{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: To conduct a grounded needs assessment to elicit community-based physicians' current views on clinical decision support (CDS) and its desired capabilities that may assist future CDS design and development for community-based practices.MATERIALS AND METHODS: To gain insight into community-based physicians' goals, environments, tasks, and desired support tools, we used a human-computer interaction model that was based in grounded theory. We conducted 30 recorded interviews with, and 25 observations of, primary care providers within 15 urban and rural community-based clinics across Oregon. Participants were members of three healthcare organizations with different commercial electronic health record systems. We used a grounded theory approach to analyze data and develop a user-centered definition of CDS and themes related to desired CDS functionalities.RESULTS: Physicians viewed CDS as a set of software tools that provide alerts, prompts, and reference tools, but not tools to support patient management, clinical operations, or workflow, which they would like. They want CDS to enhance physician-patient relationships, redirect work among staff, and provide time-saving tools. Participants were generally dissatisfied with current CDS capabilities and overall electronic health record usability.DISCUSSION: Physicians identified different aspects of decision-making in need of support: clinical decision-making such as medication administration and treatment, and cognitive decision-making that enhances relationships and interactions with patients and staff.CONCLUSION: Physicians expressed a need for decision support that extended beyond their own current definitions. To meet this requirement, decision support tools must integrate functions that align time and resources in ways that assist providers in a broad range of decisions.

Resumo Limpo

jectiv conduct ground need assess elicit communitybas physician current view clinic decis support cds desir capabl may assist futur cds design develop communitybas practicesmateri method gain insight communitybas physician goal environ task desir support tool use humancomput interact model base ground theori conduct record interview observ primari care provid within urban rural communitybas clinic across oregon particip member three healthcar organ differ commerci electron health record system use ground theori approach analyz data develop usercent definit cds theme relat desir cds functionalitiesresult physician view cds set softwar tool provid alert prompt refer tool tool support patient manag clinic oper workflow like want cds enhanc physicianpati relationship redirect work among staff provid timesav tool particip general dissatisfi current cds capabl overal electron health record usabilitydiscuss physician identifi differ aspect decisionmak need support clinic decisionmak medic administr treatment cognit decisionmak enhanc relationship interact patient staffconclus physician express need decis support extend beyond current definit meet requir decis support tool must integr function align time resourc way assist provid broad rang decis

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