ikta00074/2001 clinical information and decision support intranet system 1 science and technology...
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IKTA00074/2001 Clinical information and decision support intranet system
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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 [email protected]@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