Assigning Value to Clinical Information – A Major Limiting Factor in the Implementation of Decision-Support Systems

1996 ◽  
Vol 35 (01) ◽  
pp. 1-4 ◽  
Author(s):  
F. T. de Dombal
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Clinical Information ◽  
Limiting Factor ◽  
Major Difficulty ◽  
Computer Aided ◽  
Computer Aided Decision

AbstractThis paper deals with a major difficulty and potential limiting factor in present-day decision support - that of assigning precise value to an item (or group of items) of clinical information. Historical determinist descriptive thinking has been challenged by current concepts of uncertainty and probability, but neither view is adequate. Four equations are proposed outlining factors which affect the value of clinical information, which explain some previously puzzling observations concerning decision support. It is suggested that without accommodation of these concepts, computer-aided decision support cannot progress further, but if they can be accommodated in future programs, the implications may be profound.

Use of Diagnostic Decision Support Systems in Medical Education

2010 ◽  
Vol 49 (04) ◽  
pp. 412-417 ◽  
Author(s):  
J. J. McGowan ◽  
E. S. Berner
Keyword(s):  
Medical Education ◽  
Decision Support ◽  
Decision Support Systems ◽  
Information Seeking ◽  
Support Systems ◽  
Medical Curriculum ◽  
Clinical Information ◽  
Basic Knowledge ◽  
Research Issues ◽  
Diagnostic Decision

Summary Background: Diagnostic decision support systems are designed to assist physicians with making diagnoses. This article illustrates some of the issues that will be faced as diagnostic decision support systems become used in medical education. Objectives: The objectives of this article are to examine 1) the skills that are needed to properly use these programs as part of the students’ clinical experiences; 2) the changes that will be necessary in our curricula once these programs are more extensively utilized, including the implications of using these systems as an educational resource or simulation tool, and 3) the research issues that arise when these systems become an established part of our educational programs. Methods: This is a critical analysis of the literature on diagnostic decision support systems and medical education. Results: To optimally use diagnostic decision support programs, students will need grounding in the basic knowledge and skills that have always been necessary to become a physician, such as the ability to accurately gather and interpret clinical information from the patient. In addition, students will need specific skills in 1) selecting appropriate system vocabulary and functions, and 2) applying the diagnostic system’s suggestions to their particular patient. Conclusions: When computer-based decision support systems are incorporated in medical education, they will likely lead to changes in the traditional medical curriculum. Research will be needed on how use of these programs changes the students’ knowledge, problem-solving and information-seeking skills.

Computer-aided Modelling of Decision-support Systems

1978 ◽  
Vol 29 (8) ◽  
pp. 789-802 ◽  
Author(s):  
James Hansen ◽  
Lester E. Heitger ◽  
Lynn McKell
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Computer Aided

An Overview of Efforts to Bring Clinical Knowledge to the Point of Care

2005 ◽  
pp. 285-296
Author(s):  
Dean F. Sittig
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Support Systems ◽  
Point Of Care ◽  
Clinical Decision Support Systems ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Knowledge ◽  
The Right

By bringing people the right information in the right format at the right time and place, state of the art clinical information systems with imbedded clinical knowledge can help people make the right clinical decisions. This chapter provides an overview of the efforts to develop systems capable of delivering such information at the point of care. The first section focuses on “library-type” applications that enable a clinician to look-up information in an electronic document. The second section describes a myriad of “real-time clinical decision support systems.” These systems generally deliver clinical guidance at the point of care within the clinical information system (CIS). The third section describes several “hybrid” systems, which combine aspects of real-time clinical decision support systems with library-type information. Finally, section four provides a brief look at various attempts to bring clinical knowledge, in the form of computable guidelines, to the point of care.be sufficiently expressive to explicitly capture the design rational (process and outcome intentions) of the guideline’s author, while leaving flexibility at application time to the attending physician and their own preferred methods.” (Shahar, 2001)

ISMS: Computer-Aided Analysis for Design of Decision-Support Systems

1979 ◽  
Vol 25 (11) ◽  
pp. 1069-1081 ◽  
Author(s):  
James V. Hansen ◽  
Lynn J. McKell ◽  
Lester E. Heitger
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Computer Aided Analysis ◽  
Computer Aided

scholarly journals Information systems in the new world: an emerging national approach

2005 ◽  
Vol 29 (3) ◽  
pp. 292 ◽  
Author(s):  
Heather Grain
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Information System ◽  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Clinical Information ◽  
Advisory Council ◽  
Infrastructure Development ◽  
Health Administrator

AUSTRALIA IS ONE OF MANY countries around the world wanting to take advantage of clinical decision support systems to reduce misadventure, improve quality of care and enhance health outcomes. Policy and infrastructure developments that could remove many of the barriers to the implementation of these systems are being considered by the Australian Health Ministers? Advisory Council (AHMAC) over the next few months. These initiatives include processes for national identification of health care recipients; common approaches to consent to information sharing and access control in the electronic health care environment; secure messaging infrastructure; a national medicines directory and agreement on national terminology.1 These considerations are taking place in a context of jurisdictional cost sharing, with mutual benefits being sought. Detailed business cases have been developed, and supporting policy and practical pathways forward are actively sought. This joint policy and infrastructure development approach will seek to build consistent, shared formats and risk management, as well as shared financial responsibility. This approach is seen as more likely to lead to system change and implementation, where previously almost every advancement has succeeded in identifying more obstacles. The kind of objectives outlined above are a major underpinning of HealthConnect and state-based health information system initiatives across the country. These initiatives are extremely expensive, require significant infrastructure investment to achieve the benefits they promise, and none can be successfully implemented solely by information technology or information system professionals. It is vital that health care managers at all levels and domains of health care appreciate the success factors when making decisions about the introduction and management of these systems. The information world itself is changing for us all. These changes don?t just affect the information managers or the information technology (IT) enthusiasts found in many clinical areas of our health care organisations. As in other areas of our lives, IT has invasive effects on the clinical workplace, administration and government offices. Managers in health care are often frustrated by what is seen as a failure of IT to deliver on its promise of better decision support systems, sharing of clinical information between organisations and faster access to patient information and clinical knowledge. Nevertheless, these systems are already changing the method of collecting and using clinical information in the workplace, and are having an impact on the skills needed by all health professionals, including the health administrator.

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