The evolution of eProtocols that enable reproducible clinical research and care methods.

摘要: Unnecessary variation in clinical care and research reduces our ability to determine what healthcare interventions are effective. Reducing this unnecessary could lead further quality improvement more effective research. We have developed used electronic decision support tools (eProtocols) reduce variation. Our eProtocols progressed from a locally mainframe computer application one site (LDS Hospital) web-based applications available multiple languages internationally. use eProtocol-insulin as an example illustrate evolution. initially local effort manage stress hyperglycemia the adult intensive unit (ICU). extended translate results into usual at Intermountain Healthcare ICUs. exported other US international institutions, work pediatric ICU. iteratively refined throughout these transitions, incorporated new knowledge about managing Based on experience development of eProtocols, we outline remaining challenges eProtocol development, widespread distribution use, suggest process for development. Technical regulatory issues, well standardization protocol validation maintenance, need be addressed. Resolution issues should facilitate general improve patient care.