Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Health Care Processes and Decision Making
Lecture:The clinical process - overview of the classic paradigm
Gathering data and analyzing findings
Making a diagnosis
The impact of EHRs and technology on clinical decision-making
Slide content:Beyond the Classic Paradigm: Uncertain, Complex, High Stakes Medical Situations Patients Problems Clinicians Visits Classic paradigm 1 1 1 1 Operating room 1 1 Many 1 Acute complex illness 1 Many Many 1 or more 4.3 Table: Comparison of classic paradigm with operating room and acute complex illness Complex acute illnessmultiple disciplines, roles, tasks Short time horizon, unplanned events, uncertain data 14
Slide notes:Another setting that differs from the classic paradigm is complex acute illness. In this setting, one patient may be cared for in one or more visits by multiple clinicians dealing with multiple health problems. For example, the patient may have lung disease, kidney disease, joint disease, an infection, or preexisting chronic conditions such as diabetes and hypertension. In this scenario, multiple clinicians may perform multiple tasks over one or several patient visits. Theres often a short time horizon as well as unplanned events. Additionally, theres almost always a great deal of uncertainty about some of the data, especially in critical care settings that tend to be focused on immediate goals. Because of unanticipated events and uncertain data, clinicians must remain flexible to allow dynamic re-planning as necessary. Clinical information systems designed for such a context might have different requirements than those designed for simple one-to-one settings. 14