Evolving Clinical Information Libraries: Contextualizing Evidence Based Medicine

不断发展的临床信息库：将循证医学置于情境中

基本信息

批准号：
7903651
负责人：
KENNETH D MANDL
金额：
$ 6.43万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2011-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7903651
关键词：
Accident and Emergency department Address Antibiotic Therapy Architecture Area Awareness Beds Caring Case Study Clinical Communication Communities Coughing Data Data Sources Databases Decision Making Decision Support Systems Development Development Plans Diagnosis Digital Libraries Discipline Disease Outbreaks Electronic Health Record Electronic Mail Elements Environment and Public Health Epidemiology Evidence Based Medicine Fever Future Glean Goals Health Health system Healthcare Home environment Hospitals Individual Infant Information Networks Information Resources Information Systems Institution Knowledge Laboratories Learning Libraries Library Services Link Literature Low Grade Fever Measures Medical Medicine Modeling Parents Patients Penetration Pertussis Physicians Policies Population Primary Health Care Process Provider Public Health Publishing Reading Reporting Research Research Infrastructure Research Personnel Resources Risk Role Site Symptoms System Testing Upper Respiratory Infections Viral Work authority base care delivery clinical Diagnosis clinical care data mining data modeling design digital evidence base health record novel primary care setting public health research repository targeted delivery tool trend virtual

项目摘要

DESCRIPTION (provided by applicant): We propose planning for a paradigm of context based medicine, in which the basis for making evidence-based medical decisions includes not only traditional published medical knowledge but also evidence from highly processed clinical, environmental, and epidemiological information. Currently, such ambient contextual information is rarely available or at best used only informally by providers and patients making care decisions. The emerging national health information network creates an ideal opportunity for delivering context- appropriate information to decision makers, across institutions and disciplines. The goal of this proposal is to support what the NLM Long Range Plan calls a 21st century intelligent health system. The objective is to support, across Harvard healthcare institutions, inference, diagnosis and clinical prediction by formalizing a digital library infrastructure to facilitate acquisition, processing and delivery of highly processed, usable knowledge from clinical care sites, public health authorities, libraries and patients at home. We will conceptualize and plan a Contextualized Clinical Care Information Resource (C3IR) that links personal, environmental and population data to clinical and personal action by delivering interpreted and tailored information to clinicians through electronic health records and/or personally controlled health records and to individuals through personally controlled health records, at the point of decision. We will ground the planning and development process for this novel library service around four exemplary use cases. Our plan is to build a working model to serve the Harvard Medical community and cohere a learning community of institutional and individual users in the advancement, refinement and development of contextualized evidence based medicine.

描述（由申请人提供）：我们建议对基于上下文的医学范式进行计划，在该范式中，制定基于证据的医疗决策的基础不仅包括传统的已发表医学知识，还包括经过高度处理的临床，环境和流行病学信息的证据。目前，这种环境上下文信息很少获得或最多仅由提供者和患者做出护理决定的患者非正式地使用。新兴的国家卫生信息网络为跨机构和学科的决策者提供了上下文 - 适当的信息创造了理想的机会。该提案的目的是支持NLM远程计划所谓的21世纪智能卫生系统。目的是通过对数字图书馆基础设施进行形式化，以促进来自临床护理网站，公共卫生机构，图书馆，图书馆和家中患者的高度加工，加工和交付高度可用的知识，来支持在哈佛医疗机构之间进行推理，诊断和临床预测。我们将概念化和计划背景化的临床护理信息资源（C3IR），该信息通过电子健康记录和/或个人控制的健康记录和个人控制的健康记录通过个人控制的健康记录将个人，环境和人口数据与临床和个人行动联系起来，将其解释和量身定制的信息与临床医生联系起来。我们将在四个示例用例中为这项新型图书馆服务的计划和开发过程进行基础。我们的计划是建立一个工作模型，以服务于哈佛医学界，并在基于情境化的证据医学的进步，改进和发展机构和个人用户的学习界。