Integrating Arden-Syntax-based clinical decision support with extended presentation formats into a commercial patient data management system.

The purpose of this study was to introduce clinical decision support (CDS) that exceeds conventional alerting at tertiary care intensive care units. We investigated physicians' functional CDS requirements in periodic interviews, and analyzed technical interfaces of the existing commercial patient da...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 28; no. 5; pp. 465 - 474
Autores principales: Kraus, Stefan, Castellanos, Ixchel, Toddenroth, Dennis, Prokosch, Hans-Ulrich, Bürkle, Thomas
Formato: research Journal Article
Publicado: Springer Nature Oct2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2014
      vid: 28
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      pub: Springer Nature
      place: New York, New York
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        atl: Integrating Arden-Syntax-based clinical decision support with extended presentation formats into a commercial patient data management system.
      aug:
        au:
          Kraus, Stefan
          Castellanos, Ixchel
          Toddenroth, Dennis
          Prokosch, Hans-Ulrich
          Bürkle, Thomas
        affil: Center for Communication and Information Technology, University Hospital Erlangen, Erlangen, Germany, stefan.kraus@uk-erlangen.de.
      sug:
        subj:
          Decision Support Systems, Clinical
          Decision Support Techniques
          Management Information Systems
          Germany
          Academic Medical Centers
          Human
          Intensive Care Units
          Medical Informatics
          Monitoring, Physiologic
          Hospitals, Special
      ab: The purpose of this study was to introduce clinical decision support (CDS) that exceeds conventional alerting at tertiary care intensive care units. We investigated physicians' functional CDS requirements in periodic interviews, and analyzed technical interfaces of the existing commercial patient data management system (PDMS). Building on these assessments, we adapted a platform that processes Arden Syntax medical logic modules (MLMs). Clinicians demanded data-driven, user-driven and time-driven execution of MLMs, as well as multiple presentation formats such as tables and graphics. The used PDMS represented a black box insofar as it did not provide standardized interfaces for event notification and external access to patient data; enabling CDS thus required periodically exporting datasets for making them accessible to the invoked Arden engine. A client-server-architecture with a simple browser-based viewer allows users to activate MLM execution and to access CDS results, while an MLM library generates hypertext for diverse presentation targets. The workaround that involves a periodic data replication entails a trade-off between the necessary computational resources and a delay of generated alert messages. Web technologies proved serviceable for reconciling Arden-based CDS functions with alternative presentation formats, including tables, text formatting, graphical outputs, as well as list-based overviews of data from several patients that the native PDMS did not support.
      pubtype: Academic Journal
      doctype:
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        Journal Article
      ougenre: Article
    language: English
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