Transcript No Slide Title

Integration of Information
Resources at the Point of Need
James J. Cimino, M.D.
Departments of Medicine and
Medical Informatics
Columbia University
Information at the Point of Need
• Physicians have information needs
• Information needs go unmet
• Computer-based data contributes to the
problem
One-Stop Information Shopping?
Community
Practitioner
World Wide Web
(The Hyperdocument)
Information
Resources
Bibliographic
Database
Textbook
Expert
System
One-Touch Information Shopping
Community
Practitioner
World Wide Web
(The Facilitator)
Information
Resources
Bibliographic
Database
Textbook
Expert
System
Infobutton: Automating the Process
• Questions can be anticipated
• Match information source to question
• Automate the retrieval
• Query can use patient information
Information for Decision-Making
Information for Decision-Making
Information for Decision-Making
?
MRSA
Intelligent Decision Support
Intelligent Decision Support
Intelligent Decision Support
!
?
Query
MRSA
Result
Intelligent Decision Support
MRSA
Obstacles
MRSA
Obstacles
MRSA
1
Understand
Information
Needs
Obstacles
2
Get Information
From EMR
MRSA
1
Understand
Information
Needs
Obstacles
2
Get Information
From EMR
MRSA
1
Understand
Information
Needs
3
Resource
Selection
Obstacles
4
2
Get Information
From EMR
Resource
Terminology
MRSA
1
Understand
Information
Needs
3
Resource
Selection
Obstacles
4
Resource
Terminology
5
2
Automated
Translation
Get Information
From EMR
MRSA
1
Understand
Information
Needs
3
Resource
Selection
Obstacles
4
Resource
Terminology
6
5
2
Automated
Translation
Get Information
From EMR
MRSA
1
Querying
Understand
Information
Needs
3
Resource
Selection
Obstacles
4
Resource
Terminology
5
2
Automated
Translation
Get Information
From EMR
6
MRSA
1
Querying
Understand
Information
Needs
3
Resource
Selection
7
Presentation
Integration of Resources
•
•
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•
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•
Drug orders: to Micromedex, Medline
Culture results: to Medline
Sensitivities: to Micromedex, Medline
X-rays to: to X-rays, Medline, U. of Utah
Lab results: to DXplain
EMR: to cholesterol guideline,
mammography guideline
Summary
• On-line information sources exist
• Automated retrievals are possible
• Linking the patient-specific record to
patient-relevant medical knowledge
• Further study needed:
– how to anticipate questions
– how to find the right resources
– how to compose search strategies
– how to present results