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Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University
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Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Dec 21, 2015

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Page 1: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Integration of Information Resources at the Point of Need

James J. Cimino, M.D.

Departments of Medicine and Medical Informatics

Columbia University

Page 2: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Information at the Point of Need

• Physicians have information needs

• Information needs go unmet

• Computer-based data contributes to the problem

Page 3: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

One-Stop Information Shopping?

World Wide Web(The Hyperdocument)

InformationResources

Biblio-graphic

Database

Textbook

ExpertSystem

CommunityPractitioner

Page 4: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

One-Touch Information Shopping

InformationResources

World Wide Web(The Facilitator)

Biblio-graphic

Database

Textbook

ExpertSystem

CommunityPractitioner

Page 5: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Infobutton: Automating the Process

• Questions can be anticipated

• Match information source to question

• Automate the retrieval

• Query can use patient information

Page 6: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Information for Decision-Making

Page 7: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Information for Decision-Making

Page 8: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

?MRSA

Information for Decision-Making

Page 9: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Intelligent Decision Support

Page 10: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Intelligent Decision Support

Page 11: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Query

MRSA

Intelligent Decision Support

?

Result

!

Page 12: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

MRSA

Intelligent Decision Support

Page 13: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

MRSA

Page 14: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

UnderstandInformation

Needs

1MRSA

Page 15: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

UnderstandInformation

Needs

1

2

MRSA

Page 16: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

ResourceSelection

UnderstandInformation

Needs

1

2

3

MRSA

Page 17: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

UnderstandInformation

Needs

1

24

3

MRSA

Page 18: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

UnderstandInformation

Needs

AutomatedTranslation

1

254

3

MRSA

Page 19: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

QueryingUnderstandInformation

Needs

AutomatedTranslation

1

254

6

3

MRSA

Page 20: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

Querying

Presentation

UnderstandInformation

Needs

AutomatedTranslation

1

254

6

3

7

MRSA

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Page 48: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Integration of Resources

• Drug orders: to Micromedex, Medline

• Culture results: to Medline

• Sensitivities: to Micromedex, Medline

• X-rays to: to X-rays, Medline, U. of Utah

• Lab results: to DXplain

• EMR: to cholesterol guideline, mammography guideline

Page 49: Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University.

Summary

• On-line information sources exist• Automated retrievals are possible• Linking the patient-specific record to

patient-relevant medical knowledge• Further study needed:

– how to anticipate questions– how to find the right resources– how to compose search strategies– how to present results


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