TY -的AU -斯卡利亚,彼得AU -艾哈迈德,法盟——Schubbe丹尼尔AU - Forcino,瑞秋非盟-杜兰,Marie-Anne AU -巴尔,保罗•詹姆斯AU -埃尔温格林PY - 2021 DA - 2021/5/3 TI -集成选择网格病人决定帮助史诗电子健康记录:案例研究卫生系统5点乔- J地中海互联网Res SP - e22766六世- 23 - 5 KW -共享决策千瓦艾滋病病人决定KW -电子健康记录KW -实现千瓦HL7智能FHIR AB -背景:一些研究人员认为，将患者决策辅助(pda)成功地应用到临床工作流程中取决于将其集成到电子健康记录(EHRs)中。有趣的是，我们知道电子病历集成是一项复杂和耗时的任务;然而，这一过程尚未得到详细的研究。作为实施项目的一部分，我们检查了将症状性子宫肌瘤的偶遇PDA集成到Epic EHR系统中的工作。目的:本研究旨在确定将PDA集成到Epic EHR系统所需的步骤和时间，并检查集成工作的促进因素和障碍。方法:我们在美国5个学术医学中心进行了个案研究。每个机构的临床冠军与他们的Epic EHR团队联系，开始将子宫肌瘤选项网格pda集成到临床医生面对的菜单中。我们安排了与Epic软件分析师和Epic技术专家的定期会议，讨论如何最好地将工具集成到Epic中，以供临床医生和患者使用。然后，会议被记录下来。 Two researchers independently coded the transcripts and field notes before categorizing the codes and conducting a thematic analysis to identify the facilitators and barriers to EHR integration. The steps were reviewed and edited by an Epic technologist to ensure their accuracy. Results: Integrating the uterine fibroid Option Grid PDA into clinician-facing menus required an 18-month timeline and a 6-step process, as follows: task priority negotiation with Epic software teams, security risk assessment, technical review, Epic configuration; troubleshooting, and launch. The key facilitators of the process were the clinical champions who advocated for integration at the institutional level and the presence of an experienced technologist who guided Epic software analysts during the build. Another facilitator was the use of an emerging industry standard app platform (Health Level 7 Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources) as a means of integrating the Option Grid into existing systems. This standard platform enabled clinicians to access the tools by using single sign-on credentials and prevented protected health information from leaving the EHR. Key barriers were the lack of control over the Option Grid product developed by EBSCO (Elton B Stephens Company) Health; the periodic Epic upgrades that can result in a pause on new software configurations; and the unforeseen software problems with Option Grid (ie, inability to print the PDA), which delayed the launch of the PDA. Conclusions: The integration of PDAs into the Epic EHR system requires a 6-step process and an 18-month timeline. The process required support and prioritization from a clinical champion, guidance from an experienced technologist, and a willing EHR software developer team. SN - 1438-8871 UR - //www.mybigtv.com/2021/5/e22766 UR - https://doi.org/10.2196/22766 UR - http://www.ncbi.nlm.nih.gov/pubmed/33938806 DO - 10.2196/22766 ID - info:doi/10.2196/22766 ER -