Delivering Knowledge into the Workflow Jonathan Teich – AMDIS fall symposium, Sept. 30, 2013
Delivering Knowledge into the WorkflowJonathan Teich – AMDIS fall symposium, Sept. 30, 2013
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The Guy Who Knows
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New Condition = angina FAQs
How do Iconfirm Dx?
Gen info about angina
What are thetreatments?
What can Iexpect? (clin
course/hazards
Info about relevant MEDS
Info about relevant procedures
Disposition, re:admission criteria
NitroglycerinBeta blockers
Antiplatelet agentsHeparin
Cardiac cathPTCA (stents)
Angina OrderSet:
Meds, O2, Monitoring, x-ray,
labs
1. Order Clopidogrel FAQs
ALERT: Don’t use in
Patients takingWarfarinCheck rules
Info aboutmed
2. Procedureneeded
Procedureadvice
Information needs
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Clinical Decision Support
• CDS = “Providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care.”
• Stuff you learned once from books and journals, reformatted and delivered when and how you need them in practice
– Tailored to the current situation– Delivered for best action
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Like a GPS, CDS supplies information tailored to the current
situation, and organized for maximum value.
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Goal
We seek to repurpose the content available in books, journals, guidelines, etc.,
to deliver the most precise information and the most useful form
For any given workflow and information need
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Physician information needs and queries
• Data about hundreds of thousands of queries to MDConsult, First Consult
• Synthesized ontology of information needs
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Smart Content – turning content into action
1. Content• Curated,
maintained
2. Content indexed as discrete, reusable
facts
3. Content tailored to the situation• Matched to
insertion points, patient data, information need configuration
4. Actionable tools• External,
service-based• Integrated into
EHR screens
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Patient-specific workup options: diagnostic and therapeutic
choices
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Summary
• Knowledge is a parallel to data – they both have ontologies, coding, and could have standards
• Knowledge can be applied in different forms for different workflows and different users
• Need to balance working with EHRs, SMART sidecars, standalone references, smartphones – for the best clinical result