触发和反馈在ADR监测和数据集成平台系统设计中的应用

Application of Triggering and Feedback in ADR Monitoring and CDR System Design

目的探讨黄石市中心医院在医疗卫生信息和管理系统协会(HIMSS)7级创建过程中,在药品不良反应(ADR)监测和数据集成平台(CDR)系统设计中的药学专业参与经验。方法建立以特征文本、典型医嘱、异动检验值等多种机制来触发ADR上报,并且实现CDR系统中对患者再次开具ADR相关用药医嘱产生分级提醒。结果在医院数据集成平台中嵌入药品不良反应上报系统以后,医院ADR上报的便利性、依从性、及时性、完整性都明显提升,也有效减少药源性伤害的再次发生。结论通过侦测临床监控数据来驱动ADR信息上报,使ADR监测从线下转到线上,ADR上报从被动变成主动,同时也构建了用药安全管理的闭环。

Objective To explore and share the experience of pharmacy professionals that involved in the hospital ADR monitoring and the design of clinical data repository(CDR)during the establishment of 7-level HIMSS(Healthcare Information Management System society)in Huangshi Central Hospital.Methods A variety of mechanisms,such as feature texts,typical medication orders,and abnormal test values,was set up to trigger the ADR reporting.And grading alarm in the CDR system was achieved on patients who was prescribed ADR related medication again.Results After the ADR reporting system was embedded in the CDR,the convenience,compliance,timeliness,and integrity of hospital ADR reporting had been significantly improved,and the recurrence of drug-induced injury had also been effectively reduced.Conclusion By monitoring of clinical data to drive the ADR information reporting,the ADR monitoring is changed from offline to online,and ADR reporting is changed from passive into active.At the same time,the closed loop of drug safety management is constructed.