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

• 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
• 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

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）： 我们建议规划一种基于背景的医学范式，其中做出循证医学决策的基础不仅包括传统发表的医学知识，还包括来自高度处理的临床、环境和流行病学信息的证据。目前，此类环境背景信息很少可用，或者最多只能由提供者和患者做出护理决策时非正式地使用。新兴的国家卫生信息网络创造了一个理想的机会，可以向跨机构和学科的决策者提供适合背景的信息。 该提案的目标是支持 NLM 长期计划所谓的 21 世纪智能医疗系统。目标是通过正规化数字图书馆基础设施来支持哈佛医疗机构的推理、诊断和临床预测，以促进从临床护理场所、公共卫生当局、图书馆和家中患者获取、处理和交付经过高度处理的可用知识。我们将概念化和规划一个情境化临床护理信息资源（C3IR），通过电子健康记录和/或个人控制的健康记录向临床医生以及通过在做出决定时由个人控制健康记录。我们将围绕四个示例性用例来规划和开发这项新颖的图书馆服务。我们的计划是建立一个工作模型，为哈佛医学界服务，并凝聚机构和个人用户的学习社区，以推进、完善和发展情境化循证医学。