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首页> 外文期刊>BMC Medical Informatics and Decision Making >The eClinical Care Pathway Framework : a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections
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The eClinical Care Pathway Framework : a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections

机译：eClinical Care Pathway Framework（电子临床护理途径框架）：一种用于创建在线复杂临床护理途径的新颖结构及其在性传播感染管理中的应用

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Background Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical care pathways and its application to clinical management of people with genital chlamydia infection, the commonest sexually transmitted infection (STI) in England. Methods Using the existing evidence-base, guidelines and examples from contemporary clinical practice, we developed the e Clinical Care Pathway Framework, a nine-step iterative process. Step 1: define the aims of the online pathway; Step 2: define the functional units; Step 3: draft the clinical consultation; Step 4: expert review; Step 5: cognitive testing; Step 6: user-centred interface testing; Step 7: specification development; Step 8: software testing, usability testing and further comprehension testing; Step 9: piloting. We then applied the Framework to create a chlamydia online clinical care pathway (Online Chlamydia Pathway). Results Use of the Framework elucidated content and structure of the care pathway and identified the need for significant changes in sequences of care (Traditional: history, diagnosis, information versus Online: diagnosis, information, history) and prescribing safety assessment. The Framework met the needs of complex STI management and enabled development of a multi-faceted, fully-automated consultation. Conclusion The Framework provides a comprehensive structure on which complex online care pathways such as those needed for STI management, which involve clinical services, public health surveillance functions and third party (sexual partner) management, can be developed to meet national clinical and public health standards. The Online Chlamydia Pathway’s standardised method of collecting data on demographics and sexual behaviour, with potential for interoperability with surveillance systems, could be a powerful tool for public health and clinical management.
机译：背景技术尽管国际上有大量的eHealth推动力，但在线临床护理途径的开发尚无指导。现在，诊断技术的进步使得能够通过家庭诊断进行自我测试，可以将综合的在线临床护理与之联系起来，从而促进完全自我指导的远程护理。我们描述了开发复杂的在线临床护理途径的新框架，并将其应用于生殖器衣原体感染（在英国最常见的性传播感染）的临床管理中。方法利用现有的证据基础，当代临床实践中的指南和示例，我们开发了e临床护理途径框架，该过程分为9个步骤。步骤1：定义网上通路的目标;步骤2：定义功能单元;第三步：起草临床咨询;步骤4：专家审查;步骤5：认知测试;步骤6：以用户为中心的界面测试;步骤7：制定规范;步骤8：软件测试，可用性测试和进一步的理解测试;步骤9：试点。然后，我们应用该框架创建了衣原体在线临床护理途径（在线衣原体途径）。结果该框架的使用阐明了护理途径的内容和结构，并确定了对护理顺序（传统：历史，诊断，信息与在线：诊断，信息，历史）进行重大更改的必要性，并规定了安全性评估。该框架满足了复杂的科学，技术和创新管理的需求，并促进了多方面，全自动咨询的发展。结论该框架提供了一个全面的结构，可以开发包括临床服务，公共卫生监测职能和第三方（性伴侣）管理在内的性传播感染管理等复杂的在线护理途径，以满足国家临床和公共卫生标准。在线衣原体通路的标准化方法可以收集有关人口统计和性行为的数据，并有可能与监视系统进行互操作，这可能是公共卫生和临床管理的有力工具。

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