tailieunhanh - báo cáo khoa học: " Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain"

Tham khảo luận văn - đề án 'báo cáo khoa học: " designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Trafton et al. Implementation Science 2010 5 26 http content 5 1 26 IMPLEMENTATION SCIENCE Implementation Science RESEARCH ARTICLE Open Access Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain Jodie ATrafton 21 Susana B Martins21 1 2 Martha C Michel21 Dan Wang1 Samson WTu3 David J Clark4 Jan Elliott4 Brigit Vucic1 Steve Balt1 Michael E Clark5 Charles D Sintek6 7 Jack Rosenberg8 Denise Daniels8 and Mary K Goldstein2 1 9 Abstract Background Opioid prescribing for chronic pain is common and controversial but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system DSS to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design testing and revision of the DSS by a diverse team including guideline authors medical informatics experts clinical content experts and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record EMR and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague left decisions to clinical judgment or required clarification of .