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首页> 外文期刊>JMIR Medical Informatics >Descriptive Usability Study of CirrODS: Clinical Decision and Workflow Support Tool for Management of Patients With Cirrhosis
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Descriptive Usability Study of CirrODS: Clinical Decision and Workflow Support Tool for Management of Patients With Cirrhosis

机译：CirrODS的描述性可用性研究：用于肝硬化患者管理的临床决策和工作流程支持工具

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Background There are gaps in delivering evidence-based care for patients with chronic liver disease and cirrhosis. Objective Our objective was to use interactive user-centered design methods to develop the Cirrhosis Order Set and Clinical Decision Support (CirrODS) tool in order to improve clinical decision-making and workflow. Methods Two work groups were convened with clinicians, user experience designers, human factors and health services researchers, and information technologists to create user interface designs. CirrODS prototypes underwent several rounds of formative design. Physicians (n=20) at three hospitals were provided with clinical scenarios of patients with cirrhosis, and the admission orders made with and without the CirrODS tool were compared. The physicians rated their experience using CirrODS and provided comments, which we coded into categories and themes. We assessed the safety, usability, and quality of CirrODS using qualitative and quantitative methods. Results We created an interactive CirrODS prototype that displays an alert when existing electronic data indicate a patient is at risk for cirrhosis. The tool consists of two primary frames, presenting relevant patient data and allowing recommended evidence-based tests and treatments to be ordered and categorized. Physicians viewed the tool positively and suggested that it would be most useful at the time of admission. When using the tool, the clinicians placed fewer orders than they placed when not using the tool, but more of the orders placed were considered to be high priority when the tool was used than when it was not used. The physicians’ ratings of CirrODS indicated above average usability. Conclusions We developed a novel Web-based combined clinical decision-making and workflow support tool to alert and assist clinicians caring for patients with cirrhosis. Further studies are underway to assess the impact on quality of care for patients with cirrhosis in actual practice.
机译：背景技术在为慢性肝病和肝硬化患者提供循证护理方面存在差距。目的我们的目标是使用以用户为中心的交互式设计方法来开发肝硬化订单集和临床决策支持（CirrODS）工具，以改善临床决策和工作流程。方法召集了两个工作组，分别与临床医生，用户体验设计师，人为因素和健康服务研究人员以及信息技术人员一起创建用户界面设计。 CirrODS原型经历了几轮的造型设计。为三所医院的医师（n = 20）提供了肝硬化患者的临床情况，并比较了使用和不使用CirrODS工具时的入院顺序。医生使用CirrODS评估了他们的经验并提供了意见，我们将其编码为类别和主题。我们使用定性和定量方法评估了CirrODS的安全性，可用性和质量。结果我们创建了一个交互式CirrODS原型，当现有的电子数据表明患者处于肝硬化风险时会显示警报。该工具由两个主要框架组成，用于显示相关的患者数据，并允许对推荐的基于证据的测试和治疗进行订购和分类。医师们对该工具持积极态度，并建议该工具在入院时最有用。与使用不使用工具时相比，使用该工具时，临床医生下达的订单要少，但是使用该工具时比不使用该工具时，下达的更多命令被认为是高优先级。医师对CirrODS的评价表明其可用性高于平均水平。结论我们开发了一种新颖的基于Web的组合临床决策和工作流支持工具，以警告并协助临床医生照料肝硬化患者。正在进行进一步的研究，以评估实际操作中对肝硬化患者护理质量的影响。

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