고혈압관리 의사결정지원시스템 요구사항 규명을 위한 접근
Approach to the Requirements of a Decision Support System for Hypertension Management in a Health Center
0
조회
0
다운로드
2
인용
0
참고문헌
초록
Abstract
Background: Guidelines and protocols have gained support as vehicles for promulgating the best practices in clinical medicine, and many researchers have proposed frameworks for modeling them in a computer-interpretable format. However, for guidelines to be most useful for decision support, they need to be integrated into the patient care process and to be patient-specific. Objective: To achieve this, as a part of the development of interoperable and sharable clinical decision support system in the context of electronic health records, we identified the system requirements on the CDS for integrating hypertension management into workflow of a health center. We also introduced our approach to the acquisition of medical knowledge. Methods: A method combining the top-down and bottom-up approaches was used. For the top-down, the service scope and target group of patients were defined, and the knowledge sources, including JNC 7 and other guidelines from which decision logic was extracted, were identified. For the bottom-up approach, scenario-use cases were applied and an analysis of care data and a survey of the care providers were conducted. Results: This bidirectional method revealed the opportunities of our approach and the means by which improvements can be suggested in practice. The content and functions expected by users were also identified. These results will be used for further encoding knowledge at the computable level and application development at the implemental level. (Journal of Korean Society of Medical Informatics 13-3, 259-269, 2007)
참고문헌 (26)
- Field M, "Directions for a New Program" (1992), National Academies Press
- Musen M, "Clinical Decision-Support Systems", pp.698~736 (2006)
- Fox J, "Decision Support and Disease management: A Logic Engineering Approach", 2(4), pp.217~228 (1998)
- Boxwala A, "GLIF3:a representation format for sharable computer-interpretable clinical practice guidelines", 37(3), pp.147~161 (2004)
- Peleg M, "GLIF3: The Evolution of a Guideline Representation Format", pp.645~649 (2000), American Medical Informatics Association
- Shahar Y, "The Asgaard project: A task-specific framework for the application and critiquing of time-oriented clinical guidelines", 14, pp.29~51 (1998)
- Quaglini S, "Guideline-based careflow systems", 20(1), pp.5~22 (2000)
- Purves I, "The PRODIGY project - the iterative development of the release one model", pp.359~363 (1999)
- Kim Y, "Research and Development Efforts Aimed at Implementing Electronic Health Record Systems with Interoperability and Patient Safety", 12(2), pp.115~132 (2006)
- World Health Organization, "2003 World Health Organization", International Society of Hypertension statement on management of hypertension, 2003, pp.21, 1983~1992[DOI]
- Guidelines Committee, "2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension", 21, pp.1011~1053 (2003)
- Ministry of Health and Welfare, "Guidelines of chronic disease management project 2005" (2005), Seoul: Ministry of Health and Welfare
- Maviglia S, "Automating complex guidelines for chronic disease: lessons learned", 10(2), pp.154~165 (2003)
- Blood pressure lowering treatment trialists’ collaboration, "Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials", 362, pp.1527~1535 (2003)
- Hemmelgarn B, "Canadian Hypertension Education Program recommendations for the management of hypertension", 22(7), pp.573~593 (2006)
- Kaplan N, "Kaplan′s clinical hypertension" (2006), Philadelphia:Lippincott Williams & Wilkins
- North of England Hypertension Guideline Development Group, "hypertension:managing adult patients in primary care" (2004), Newcastle upon Tyne (UK):Centre for Health Services Research
- Scottish intercollegiate guidelines network, "Hypertension in older people:Edinburgh:Scottish intercollegiate guidelines network" (2001)
- The Korean Association of Internal Medicine, "Clinical Guidelines for resident of Internal Medicine" (2004), The Korean Association of Internal Medicine
- The Korean Society of Hypertension, "2004 Korean Hypertension Treatment Guidelines" (2004), Seoul:The Korean Society of Hypertension
- University of Michigan Health System, "Essential hypertension" (2003), Ann Arbor (MI):University of Michigan Health System
- Veterans Administration, "Department of Defense. VA", DoD clinical practice guideline for diagnosis and management of hypertension in the primary care setting, 2005, ~[DOI]
- Williams B, "Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-British hypertension society IV", 18, pp.139~185 (2004)
- Abarbanel R, "Partnerships in Innovation: How We Accomplished the Objectives of the SAGE Project", pp.1176~1178 (2006)
- Zheng K, "Understanding technology adoption in clinical care: Clinician adoption behavior of a point-of-care reminder system", 74, pp.535~543 (2005)
- Osheroff J, "Improving Outcomes with Clinical Decision Support: An Implementer′s Guide" (2005), Healthcare Information and Management Systems Society
