Science and technology Clinical information and decision support

Science and technology Clinical information and decision support intranet system: “The Bed Side Story” IKTA 0074/2001 Szeged, Hungary IKTA 00074/2001 Clinical information and decision support intranet system

Project sheet Consortial members: • Csongrád Megyei MEDNET Kht. - Co-ordinator • Department of Medical Informatics, University of Szeged • Department of Clinical Pharmacology, University of Szeged Implementation period: 01/01/2002 - 06/30/2004 Duration: 30 months Total implementation cost approx: € 355. 000. * *Rate: 245 HUF/€ IKTA 00074/2001 Clinical information and decision support intranet system

The dilemma „Half of we know today won’t be true in three years time The problem is that we don’t know which half…” IKTA 00074/2001 Clinical information and decision support intranet system

The decision space intuition external evidence EBM conviction formal problem solving knowledge-based (KBDS) solutions IKTA 00074/2001 Clinical information and decision support intranet system

Problems 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 IKTA 00074/2001 Clinical information and decision support intranet system

Aims To develop a knowledge-based clinical information & decision support system IKTA 00074/2001 Clinical information and decision support intranet system

System I/O modell Drug data Rx guideline IKTA 00074/2001 Clinical information and decision support intranet system reference Decision support system warning interface Clinical lab data (LAB) interface Patient data (PMS) reminder

Main features • Medical knowledge (ebooks): • clinical handbook • drug information • laboratory handbook • Decision support: • Doseprompt - case specific, protocol-based drug administration • Labprompt - case specific (clinical chemistry lab) result illustration interpretation IKTA 00074/2001 Clinical information and decision support intranet system

Main features 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? IKTA 00074/2001 Clinical information and decision support intranet system

Main features 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? IKTA 00074/2001 Clinical information and decision support intranet system

Knowledge 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 IKTA 00074/2001 Clinical information and decision support intranet system

Knowledge organization - ebook IKTA 00074/2001 Clinical information and decision support intranet system

Advanteges • Instant access of medical knowledge • structured knowledge representation • automated decision support elements, • case specific advice • integration with the clinical work-flow IKTA 00074/2001 Clinical information and decision support intranet system

Envisioned IT environment Clinical intranet portal SMS/WAP LAN HIS PMS SMS/WAP LAB Hospital information system IKTA 00074/2001 Clinical information and decision support intranet system GSM service ISDN GP Office

Contact Dr. András APJOK apjok@mednetkht. hu Csongrád Megyei MEDNET Kht. Korányi fasor 9. Szeged, Hungary H-6720 Phone/fax: +36 62 54 58 66 IKTA 00074/2001 Clinical information and decision support intranet system