Open Source Medical Decision Support Systems DSS

Presentation Transcript

Open Source Medical Decision Support Systems (DSS)

What is a DSS System? EMR/CIS/HIS (portrayal of patient) + New Symptoms Decision Support 

What's the Problem? Doctors are overpowered. Inadequate time accessible for analysis and treatment. Lacking time accessible to remain side by side of most recent improvements. Rate of distributed review comes about/therapeutic confirmation expanding. Normally 17 year slack from disclosure to enhanced patient care. Conflicting utilization of information prompts to poor care. Some in the third world will never observe a doctor paying little heed to their need.

What's the Problem? Mistake rates in the U.S. are high. 44,000 to 98,000 passings because of restorative mistake every year. 2.4 million medicine mistakes in one year in Massachusetts alone. $17 Billion spent on preventable blunders every year. Costs for restorative care are expanding quickly. Will we discover approaches to enhance cost versus mind?

Existing Medical DSS Systems 70 known exclusive DSS Systems. Just 10 of 70 equipped towards General Practice. All require propelled specialized learning. None permit source access to change interface to Clinical. Data Systems (CIS). Just a single is correctable/updateable by end client. Created with little thought of end clients "..so far the frameworks have neglected to increase wide acknowledgment by doctors." Proprietary endeavors to help doctors have fizzled. Cost to create valuable database outside reach of one organization.

Proposed Solution Clinical Decision Support System (DSS). More doctor quality time with patients for finding and treatment. Moment suggestions from a "specialist" Improved care and exactness of determinations. Lessen obligation protection premiums. Decrease the quantity of office visits to determine conditions. Decrease the quantity of medications endeavored to determine conditions. Halfway answer for medicinal services in underdeveloped nations that may never observe a genuine doctor.

Proposed Solution Clinical Decision Support System (DSS). Permits confirmation of information not effortlessly accessible for exclusive arrangements. Permits refreshes in a convenient and companion reviewable (e.g. Rule International Network or NGC) way. Reconciliation is conceivable with EMR/CIS/HIS for record keeping and more nitty gritty determinations in view of provincial measurements and previous history. Decrease in the general cost per man-hour.

Features of DSS Describe Condition of Patient utilizing Standards Use ASTM advisory group E31.28 Continuity of Care Record (CCR) Standard or HL7 Clinical Doc Arch. Benchmarks approach facilitates interface with different frameworks, including restrictive frameworks.

Features of DSS Describe Clinical Guidelines and Diseases utilizing Standards Several norms being considered for harmonization. GLIF3 has a great deal of support. Norms approach facilitates interface with different frameworks, including restrictive frameworks.

Features of DSS Simplified Graphical User Interface. Accomplish for therapeutic choice emotionally supportive networks what web programs accomplished for the web, what GUI accomplished for PC's and PDA's. Usable by anybody, including doctors, medical attendants and patients . Base on open-source data (e.g. noticeable human venture.)

Issues Privacy concerns/laws. No code imparted to EMR/CIS/HIS. Tolerant personality not imparted to DSS framework. Huge measure of information and tenets must be fused into framework. National Health Information Technology Coordinator made in 2004 to empower/subsidize electronic wellbeing activities. Resistance/work fears of clinicians Goal is to help clinicians, not supplant them.

Issues Clinical Trial Hurdles. Make proposals, not analyze. Disclaimers with respect to utilize. Every past exertion have neglected to accomplish basic use. Incorporate end clients (doctors, attendants, schedulers, IT offices) in the plan choices and testing. Iterative plan approach (i.e. adjust in light of input.)

Existing Open Source Example EGADSS framework: Interfaces with EMR/CIS as it were. - No immediate side effect inputs. Institutional support and financing. Suggested Modifications: Add GUI for patient/doctor coordinate get to. Bolster improvement of Computer Interpretable Clinical Guidelines (CIG).

Where do we go from here? Advance open source Computer Interpretable clinical Guideline (CIG) information base improvement at the government level with proceeding with upkeep from AHRQ. Every one of the 70+ exclusive endeavors to create learning bases have fizzled. AHRQ as of now keeps up composed clinical rules AHRQ speaks to the U.S. for universal verifying of clinical rules. Financing opportunity in up and coming HIT enactment Form IEEE think about gathering on clinical interfaces and frameworks. Survey past examinations of clinical interfaces. Work with specialists, medical attendants, clinics, HMO's, and so on to acquire info and input. Perform human elements considers, if justified. Grow needs proclamation or programming particular for clinical interfaces.

Sources EGADSS: http://www.egadss.org : Slides 2, 3, 4, 13 Whyatt and Spiegelhalter ( http://www.computer.privateweb.at/judith/index.html ): Slides 5 OpenClinical ( http://www.openclinical.org/home.html ): Slides 7 Solventus ( http://www.solventus.com/aquifer ): Slides 2, 8 Conversations with Dan Smith at ASTM: Slide 8 Agency for Healthcare, Research and Quality/AHRQ ( http://www.ahrq.gov/and http://www.guideline.gov ): slide 9, 11 WebMD ( http://my.webmd.com/medical_information/check_symptoms ): Slide 2, 10