medexter ® Vom Forschungsergebnis in die klinische Routine – Klinische Entscheidungsunterstützung mit Moni-ICU Klaus-Peter Adlassnig Section for Medical Expert and Knowledge-Based Systems Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna Spitalgasse 23 A-1090 Vienna, Austria and Medexter Healthcare GmbH Borschkegasse 7/5 A-1090 Vienna, Austria Workshop GMDS-Arbeitsgruppe „Wissensbasierte Systeme in der Medizin“, Berlin, 04 April 2011
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medexter®
Vom Forschungsergebnis in die klinische Routine –Klinische Entscheidungsunterstützung mit Moni-ICU
Klaus-Peter Adlassnig
Section for Medical Expert and Knowledge-Based SystemsCenter for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaSpitalgasse 23A-1090 Vienna, Austria
and
Medexter Healthcare GmbHBorschkegasse 7/5A-1090 Vienna, Austria
Workshop GMDS-Arbeitsgruppe „Wissensbasierte Systeme in der Medizin“, Berlin,04 April 2011
• 35 HELICS + 19 KISS definitions of ICU-acquired infections– 6 + 3 definitions of bloodstream infections– 17 + 9 definitions of ICU-acquired pneumonias– 9 + 7 definitions of urinary tract infections– 3 + 0 definitions of central venous catheter-related infections
• Moni-ICU is operated at 12 ICUs at the Vienna GeneralHospital (96 beds)
• Moni-ICU is connected to HIS, LIS, and PDMS
• cockpit surveillance for infection control unit– automated daily and/or manual activation
• evaluation over a period of 2 months (2 ICUs)– 24 out of 28 patients TP (detected and correct), 0 FPs, 4 FNs (cause:
missing data, variable missing in rule condition, …), many TNs– manual evaluation of criteria: each episode of infection > 2 hours– with Moni: < 5 min per episode
medexter®
Sources of success
• clinical* no diagnoses* two-step reporting
• methodological* pure knowledge-based system* consensual classification criteria* hierarchical layers of data and knowledge* fuzzy set theory and logic
• technical* separation of PDMS data collection, service-oriented rule engine server,
knowledge packages, and web-based infection control application* integration of different hospital IT systems (HIS, LIS, PDMS, CDSS server)
• administrative* no additional data entry* almost uniform PDMS data sources at 12 ICUs* support by medical administration* several lead users