ikta00074/2001 clinical information and decision support intranet system 1 science and technology...

IKTA00074/2001 Clinical information and decision support intranet system

1

Science and technologyScience and technology

Clinical information and decision Clinical information and decision support intranet system:support intranet system:

““The Bed Side Story”The Bed Side Story”

IKTA0074/2001IKTA0074/2001

Szeged, HungarySzeged, Hungary

IKTA00074/2001 Clinical information and decision support intranet system

2Project sheetProject sheet

Consortial members:Consortial members:

• Csongrád Megyei MEDNET Kht. - Co-ordinatorCsongrád Megyei MEDNET Kht. - Co-ordinator

• Department of Medical Informatics, University of SzegedDepartment of Medical Informatics, University of Szeged

• Department of Clinical Pharmacology, University of SzegedDepartment of Clinical Pharmacology, University of Szeged

Implementation period: Implementation period: 01/01/2002 - 06/30/200401/01/2002 - 06/30/2004

Duration: 30 monthsDuration: 30 months

Total implementation cost approx: Total implementation cost approx: €355.000.*€355.000.**Rate: 245HUF/€*Rate: 245HUF/€

IKTA00074/2001 Clinical information and decision support intranet system

3The dilemmaThe dilemma

„Half of we know today won’t be true in three years time

The problem is that we don’t know which half…”

IKTA00074/2001 Clinical information and decision support intranet system

4The decision spaceThe decision space

formal problem solving

convictionexternal evidence

intuition

formal problem solving

knowledge-based (KBDS) solutions

formal problem solving

knowledge-based (KBDS) solutions

external evidence

EBM

external evidence

EBM

IKTA00074/2001 Clinical information and decision support intranet system

5Problems with CDSSProblems with CDSS

Clinical Decision Support Systems

Reasons not to use computerized clinical

decision support systems in practice:

• The required knowledge does not available

at bedside

• The advice is general, not case specific

• no integration with the clinical work-flow

IKTA00074/2001 Clinical information and decision support intranet system

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To develop a knowledge-basedTo develop a knowledge-based

clinical information &clinical information &

decision supportdecision support

systemsystem

AimsAims

IKTA00074/2001 Clinical information and decision support intranet system

7System I/O modellSystem I/O modell

DecisionDecisionsupportsupportsystemsystem

interface

inte

rface

inte

rface

Clinical labdata(LAB)

Patient data(PMS)

Drug data

Rx

guideline warningreference reminder

IKTA00074/2001 Clinical information and decision support intranet system

8Main featuresMain features

• Medical knowledge (Medical knowledge (eebooks):books):• clinical handbook• drug information• laboratory handbook

• Decision supportDecision support::• Doseprompt - case specific, protocol-based drug administration• Labprompt - case specific (clinical chemistry lab) result interpretationillustrationillustration

IKTA00074/2001 Clinical information and decision support intranet system

9Main features Main features cont.cont.

Doseprompt - Clinical questions to be answered

@bedside:

• What drug should be given?

• How should it be administered?

• What is the correct dose?

• Given the strenght and form of the selected drug

what is the correct quantity to be expediated?

IKTA00074/2001 Clinical information and decision support intranet system

10Main features Main features cont.cont.

Labprompt - Clinical questions to be answered

@bedside:

• What test should be ordered?

• What is the correct interpretation of the results?

• What are the implications?

IKTA00074/2001 Clinical information and decision support intranet system

11Knowledge organisation principlesKnowledge organisation principles

• Knowledge must be organized around the main

clinical questions

• It must be organized redundacy free but in a flexible

structure allowing fast and targeted access

• evidence-based knowledge is preferred

• In practice a set of related core texts, guidelines, and

articles are identified knowledge is extracted, updated,

reorganized and new elements are added

• Peaces of kowledge are to be cross referenced

• Sources must be clearly indicated

IKTA00074/2001 Clinical information and decision support intranet system

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Knowledge organization - Knowledge organization - eebookbook

IKTA00074/2001 Clinical information and decision support intranet system

13AdvantegesAdvanteges

• Instant access of medical knowledge

• structured knowledge representation

• automated decision support elements,

• case specific advice

• integration with the clinical work-flow

IKTA00074/2001 Clinical information and decision support intranet system

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GSMGSMserviceservice

GP OfficeGP Office

Clinical intranetClinical intranetportalportal

PMS

HIS

Hospital informationsystem

LAB

LAN

SMS/WAP

SMS/WAP

ISDN

Envisioned IT environmentEnvisioned IT environment

IKTA00074/2001 Clinical information and decision support intranet system

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ContactContact

Dr. András APJOKDr. András APJOKapjok@mednetkht.huapjok@mednetkht.hu

Csongrád Megyei MEDNET Kht.Csongrád Megyei MEDNET Kht.Korányi fasor 9.Korányi fasor 9.

Szeged, HungarySzeged, HungaryH-6720H-6720

Phone/fax: +36 62 54 58 66Phone/fax: +36 62 54 58 66