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首页> 外文学位 >The design and analysis of an informatics infrastructure to support clinical decision making in the management of opioid PCA infusions for palliative patients.
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The design and analysis of an informatics infrastructure to support clinical decision making in the management of opioid PCA infusions for palliative patients.

机译：信息学基础设施的设计和分析，可为姑息患者的阿片类PCA输注的管理提供支持以支持临床决策。

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摘要

Though medical advances in the last century now allow us to forestall death, many patients suffer from significant symptoms as they battle severe disease. Opioid medications are particularly effective when treating pain in these patients and infusion by the patient controlled analgesia (PCA) paradigm is commonly used in patients with severe disease. While PCA allows rapid titration yet individualized adjustment of opioid dose, it involves complex, high-stakes decisions. Unfortunately, clinicians complain that it is often difficult or impossible to find the data needed to make these decisions. A relevant data display could support clinical decisions by providing real-time up-to-date clinical data at the point of care.;Literature synthesis and multiple modeling techniques were used to quantify the domain. An inductive, qualitative approach, including graphical mapping techniques, was used to build a foundational domain information model which was subsequently validated using a survey of domain experts. A gap analysis was performed, mapping concepts from the information model to the emerging HL7 FHIR standard.;Modeling revealed a complex workflow, highlighted the bottleneck in information flow to providers at the point of care, and supported the premise that a relevant data display would be beneficial. The gap analysis showed that currently existing FHIR resources are capable of representing all relevant concepts from the domain information model needed for decision making in this complex use-case. Potential problems with FHIR implementation were identified and recommendations to address these are presented.
机译：尽管上世纪的医学进步使我们能够预防死亡，但许多患者在与严重疾病作斗争时遭受明显症状。阿片类药物在治疗这些患者的疼痛时特别有效，而患者自控镇痛（PCA）范例的输注通常用于重症患者。虽然PCA可以快速滴定，但可以对阿片类药物剂量进行个性化调整，但它涉及复杂，高风险的决策。不幸的是，临床医生抱怨通常很难或不可能找到做出这些决定所需的数据。通过在护理点提供实时的最新临床数据，相关的数据显示可以支持临床决策。;文献合成和多种建模技术用于量化领域。归纳，定性的方法，包括图形映射技术，被用于建立基础的域信息模型，随后使用域专家调查对其进行验证。进行了差距分析，将概念从信息模型映射到新兴的HL7 FHIR标准。建模揭示了复杂的工作流程，突出了在护理点流向提供者的信息流的瓶颈，并支持以相关数据显示为前提是有益的。差距分析表明，当前存在的FHIR资源能够代表该复杂用例中进行决策所需的域信息模型中的所有相关概念。确定了实施FHIR的潜在问题，并提出了解决这些问题的建议。

著录项

  • 作者

    Clutter, Justin D.;

  • 作者单位

    The University of Utah.;

  • 授予单位 The University of Utah.;
  • 学科 Health care management.;Nursing.;Information science.
  • 学位 M.S.
  • 年度 2016
  • 页码 153 p.
  • 总页数 153
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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