Computer clinical decision support that automates personalized clinical care: a challenging but needed healthcare delivery strategy.

Autor:	Morris AH; Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Horvat C; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Stagg B; Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah, Salt Lake City, Utah, USA., Grainger DW; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA., Lanspa M; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Orme J; Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Clemmer TP; Department of Internal Medicine (Critical Care), Intermountain Healthcare, Salt Lake City, Utah, USA., Weaver LK; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Thomas FO; Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA., Grissom CK; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Hirshberg E; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., East TD; SYNCRONYS - Chief Executive Officer, Albuquerque, New Mexico, USA., Wallace CJ; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Young MP; Department of Critical Care, Renown Regional Medical Center, Reno, Nevada, USA., Sittig DF; School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA., Suchyta M; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Pearl JE; Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.; Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA., Pesenti A; Faculty of Medicine and Surgery-Anesthesiology, University of Milan, Milano, Lombardia, Italy., Bombino M; Department of Emergency and Intensive Care, San Gerardo Hospital, Monza (MB), Italy., Beck E; Faculty of Medicine and Surgery - Anesthesiology, University of Milan, Ospedale di Desio, Desio, Lombardia, Italy., Sward KA; Department of Biomedical Informatics, College of Nursing, University of Utah, Salt Lake City, Utah, USA., Weir C; Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA., Phansalkar S; Wolters Kluwer Health-Clinical Solutions-Medical Informatics, Wolters Kluwer Health, Newton, Massachusetts, USA., Bernard GR; Vanderbilt University School of Medicine, Nashville, Tennessee, USA., Thompson BT; Pulmonary and Critical Care Division, Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts, USA., Brower R; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA., Truwit J; Department of Internal Medicine, Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Steingrub J; Department of Internal Medicine, Pulmonary and Critical Care, University of Massachusetts Medical School, Baystate Campus, Springfield, Massachusetts, USA., Hiten RD; Department of Internal Medicine, Pulmonary and Critical Care, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Willson DF; Pediatric Critical Care, Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia, USA., Zimmerman JJ; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA., Nadkarni V; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Randolph AG; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA., Curley MAQ; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA., Newth CJL; Childrens Hospital Los Angeles, Department of Anesthesiology and Critical Care, University of Southern California Keck School of Medicine, Los Angeles, California, USA., Lacroix J; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Université de Montréal Faculté de Médecine, Montreal, Quebec, Canada., Agus MSD; Division of Medical Pediatric Critical Care, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Lee KH; Department of Intensive Care Medicine, Ng Teng Fong Hospital and National University Centre of Transplantation, National University Singapore Yong Loo Lin School of Medicine, Singapore., deBoisblanc BP; Department of Internal Medicine, Pulmonary and Critical Care, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA., Moore FA; Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA., Evans RS; Department of Medical Informatics, Intermountain Healthcare, and Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA., Sorenson DK; Department of Medical Informatics, Intermountain Healthcare, Salt Lake City, Utah, USA., Wong A; Department of Data Science Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Boland MV; Department of Ophthalmology, Massachusetts Ear and Eye Infirmary, Harvard Medical School, Boston, Massachusetts, USA., Dere WH; Endocrinology and Metabolism Division, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA., Crandall A; Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.; Posthumous., Facelli J; Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA., Huff SM; Department of Medical Informatics, Intermountain Healthcare, Department of Biomedical Informatics, University of Utah, and Graphite Health, Salt Lake City, Utah, USA., Haug PJ; Department of Medical Informatics, Intermountain Healthcare, and Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA., Pielmeier U; Aalborg University Faculty of Engineering and Science - Department of Health Science and Technology, Respiratory and Critical Care Group, Aalborg, Nordjylland, Denmark., Rees SE; Aalborg University Faculty of Engineering and Science - Department of Health Science and Technology, Respiratory and Critical Care Group, Aalborg, Nordjylland, Denmark., Karbing DS; Aalborg University Faculty of Engineering and Science - Department of Health Science and Technology, Respiratory and Critical Care Group, Aalborg, Nordjylland, Denmark., Andreassen S; Aalborg University Faculty of Engineering and Science - Department of Health Science and Technology, Respiratory and Critical Care Group, Aalborg, Nordjylland, Denmark., Fan E; Internal Medicine, Pulmonary and Critical Care Division, Institute of Health Policy, Management and Evaluation, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Goldring RM; Department of Internal Medicine, Pulmonary and Critical Care, New York University School of Medicine, New York, New York, USA., Berger KI; Department of Internal Medicine, Pulmonary and Critical Care, New York University School of Medicine, New York, New York, USA., Oppenheimer BW; Department of Internal Medicine, Pulmonary and Critical Care, New York University School of Medicine, New York, New York, USA., Ely EW; Internal Medicine, Pulmonary and Critical Care, Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee, USA., Pickering BW; Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA., Schoenfeld DA; Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA., Tocino I; Department of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA., Gonnering RS; Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Pronovost PJ; Department of Anesthesiology and Critical Care Medicine, University Hospitals, Highland Hills, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA., Savitz LA; Northwest Center for Health Research, Kaiser Permanente, Oakland, California, USA., Dreyfuss D; Assistance Publique-Hôpitaux de Paris, Université de Paris, Sorbonne Université - INSERM unit UMR S_1155 (Common and Rare Kidney Diseases), Paris, France., Slutsky AS; Interdepartmental Division of Critical Care Medicine, Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Crapo JD; Department of Internal Medicine, National Jewish Health, Denver, Colorado, USA., Pinsky MR; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., James B; Department of Internal Medicine, Clinical Excellence Research Center (CERC), Stanford University School of Medicine, Stanford, California, USA., Berwick DM; Institute for Healthcare Improvement, Cambridge, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2022 Dec 13; Vol. 30 (1), pp. 178-194.
DOI:	10.1093/jamia/ocac143
Abstrakt:	How to deliver best care in various clinical settings remains a vexing problem. All pertinent healthcare-related questions have not, cannot, and will not be addressable with costly time- and resource-consuming controlled clinical trials. At present, evidence-based guidelines can address only a small fraction of the types of care that clinicians deliver. Furthermore, underserved areas rarely can access state-of-the-art evidence-based guidelines in real-time, and often lack the wherewithal to implement advanced guidelines. Care providers in such settings frequently do not have sufficient training to undertake advanced guideline implementation. Nevertheless, in advanced modern healthcare delivery environments, use of eActions (validated clinical decision support systems) could help overcome the cognitive limitations of overburdened clinicians. Widespread use of eActions will require surmounting current healthcare technical and cultural barriers and installing clinical evidence/data curation systems. The authors expect that increased numbers of evidence-based guidelines will result from future comparative effectiveness clinical research carried out during routine healthcare delivery within learning healthcare systems. (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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