Patient-centered clinical decision support challenges and opportunities identified from workflow execution models.
J Am Med Inform Assoc
; 31(8): 1682-1692, 2024 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-38907738
ABSTRACT
OBJECTIVE:
To use workflow execution models to highlight new considerations for patient-centered clinical decision support policies (PC CDS), processes, procedures, technology, and expertise required to support new workflows.METHODS:
To generate and refine models, we used (1) targeted literature reviews; (2) key informant interviews with 6 external PC CDS experts; (3) model refinement based on authors' experience; and (4) validation of the models by a 26-member steering committee. RESULTS ANDDISCUSSION:
We identified 7 major issues that provide significant challenges and opportunities for healthcare systems, researchers, administrators, and health IT and app developers. Overcoming these challenges presents opportunities for new or modified policies, processes, procedures, technology, and expertise to (1) Ensure patient-generated health data (PGHD), including patient-reported outcomes (PROs), are documented, reviewed, and managed by appropriately trained clinicians, between visits and after regular working hours. (2) Educate patients to use connected medical devices and handle technical issues. (3) Facilitate collection and incorporation of PGHD, PROs, patient preferences, and social determinants of health into existing electronic health records. (4) Troubleshoot erroneous data received from devices. (5) Develop dashboards to display longitudinal patient-reported data. (6) Provide reimbursement to support new models of care. (7) Support patient engagement with remote devices.CONCLUSION:
Several new policies, processes, technologies, and expertise are required to ensure safe and effective implementation and use of PC CDS. As we gain more experience implementing and working with PC CDS, we should be able to begin realizing the long-term positive impact on patient health that the patient-centered movement in healthcare promises.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Atención Dirigida al Paciente
/
Sistemas de Apoyo a Decisiones Clínicas
/
Flujo de Trabajo
Idioma:
En
Revista:
J Am Med Inform Assoc
Asunto de la revista:
INFORMATICA MEDICA
Año:
2024
Tipo del documento:
Article