IKTA00074/2001 Cli nical information and decision suppo rt intranet system 1 Science and technology Science and technology Clinical information and decision Clinical information and decision support intranet system: support intranet system: “ “ The Bed Side Story” The Bed Side Story” IKTA0074/2001 IKTA0074/2001 Szeged, Hungary Szeged, Hungary
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IKTA00074/2001 Clinical information and decision support intranet system 1 Science and technology Clinical information and decision support intranet system:
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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
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
6
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