21st century (clinical) decision support in nursing and allied healthcare. Developing a learning health system: a reasoned design of a theoretical framework.

Autor: van Velzen M; Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands. m.van.velzen@hr.nl.; Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands. m.van.velzen@hr.nl., de Graaf-Waar HI; Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.; Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands., Ubert T; Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands., van der Willigen RF; Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands., Muilwijk L; Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.; Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands., Schmitt MA; Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands., Scheper MC; Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.; Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands.; Allied Health professions, faculty of medicine and science, Macquarrie University, Sydney, Australia., van Meeteren NLU; Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands.; Top Sector Life Sciences and Health (Health~Holland), The Hague, the Netherlands.
Jazyk: angličtina
Zdroj: BMC medical informatics and decision making [BMC Med Inform Decis Mak] 2023 Dec 05; Vol. 23 (1), pp. 279. Date of Electronic Publication: 2023 Dec 05.
DOI: 10.1186/s12911-023-02372-4
Abstrakt: In this paper, we present a framework for developing a Learning Health System (LHS) to provide means to a computerized clinical decision support system for allied healthcare and/or nursing professionals. LHSs are well suited to transform healthcare systems in a mission-oriented approach, and is being adopted by an increasing number of countries. Our theoretical framework provides a blueprint for organizing such a transformation with help of evidence based state of the art methodologies and techniques to eventually optimize personalized health and healthcare. Learning via health information technologies using LHS enables users to learn both individually and collectively, and independent of their location. These developments demand healthcare innovations beyond a disease focused orientation since clinical decision making in allied healthcare and nursing is mainly based on aspects of individuals' functioning, wellbeing and (dis)abilities. Developing LHSs depends heavily on intertwined social and technological innovation, and research and development. Crucial factors may be the transformation of the Internet of Things into the Internet of FAIR data & services. However, Electronic Health Record (EHR) data is in up to 80% unstructured including free text narratives and stored in various inaccessible data warehouses. Enabling the use of data as a driver for learning is challenged by interoperability and reusability.To address technical needs, key enabling technologies are suitable to convert relevant health data into machine actionable data and to develop algorithms for computerized decision support. To enable data conversions, existing classification and terminology systems serve as definition providers for natural language processing through (un)supervised learning.To facilitate clinical reasoning and personalized healthcare using LHSs, the development of personomics and functionomics are useful in allied healthcare and nursing. Developing these omics will be determined via text and data mining. This will focus on the relationships between social, psychological, cultural, behavioral and economic determinants, and human functioning.Furthermore, multiparty collaboration is crucial to develop LHSs, and man-machine interaction studies are required to develop a functional design and prototype. During development, validation and maintenance of the LHS continuous attention for challenges like data-drift, ethical, technical and practical implementation difficulties is required.
(© 2023. The Author(s).)
Databáze: MEDLINE
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