%0期刊文章%@ 1438- 8871% I JMIR出版物%V 22卡塔尔世界杯8强波胆分析% N 10% P e22013 %T通过与患者共享低水平警报和增强使用区块链技术的协作决策来减少警报疲劳:范围审查和建议框架(MedAlert) %A Wan,Paul Kengfai %A Satybaldy,Abylay %A Huang,Lizhen %A Holtskog,Halvor %A Nowostawski,Mariusz %+挪威科技大学制造和土木工程系，Teknologiveien 22, gj æ vik, 2815, Norway, 47 93984604，paul.k.wan@ntnu.no %K区块链%K医疗保健%K警报疲劳%K临床决策支持%K智能合约%K信息共享%D 2020 %7 28.10.2020 %9原始论文%J J医学Internet Res %G英文%X背景:临床决策支持(CDS)是一种工具，通过生成临床警报来补充临床医生以前的知识和经验，帮助临床医生进行决策。然而，CDS产生大量无关的警报，导致临床医生警惕疲劳。警报疲劳是警报消耗太多时间和精力的精神状态，通常会导致相关警报被不合理地覆盖，以及临床无关的警报。因此，临床医生对重要警报的反应变得不那么灵敏，这为用药错误打开了大门。目的:本研究旨在探索基于区块链的解决方案如何通过卫生部门的协作警报共享来减少警报疲劳，从而提高患者和临床医生的整体医疗质量。方法:我们设计了一个4步的方法来回答这个研究问题。首先，我们根据已发表的文献通过范围审查确定了五个潜在的挑战。其次，设计了一个框架，通过解决不同数字组件所确定的挑战来减少警报疲劳。 Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed. Results: Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues. Conclusions: MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea. %M 33112253 %R 10.2196/22013 %U //www.mybigtv.com/2020/10/e22013/ %U https://doi.org/10.2196/22013 %U http://www.ncbi.nlm.nih.gov/pubmed/33112253