Transcript Intelligent Patient Data Review Assistant

An Intelligent Patient Data
Review Assistant (IPDRA)
AMIA Medinfo 2004
Jim Ong, MS Stottler Henke
LTC Trinka Coster, MD
Matthew Medlock, MD
LTC Joseph Parker, MD
Jane Dowling, MS
Stephen Porter, MD
Seth Powsner, MD
Ida Sim, MD PhD
Walter Reed Army Institute of Research
Uniformed Services Univ. of the Health Sciences
Walter Reed Army Medical Center
NYU Medical Center
Harvard Medical School
Yale University School of Medicine
UC San Francisco School of Medicine
This research was funded by the U.S. Department of Defense.
IPDRA Mission
Help clinicians review patient data more effectively
before, during, and after patient encounters
Current Web application server
state-of-the-art Relational database
Source-oriented queries
Modest use of graphics
Limitations Time-consuming to query related patient
data from different parts of the database
.
Hard to mentally integrate data spanning
multiple pages and data sources
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
IPDRA Approach
Patient Present integrated, clinically-meaningful
data views subsets of each patient’s records
(by problem, body system, demographic).
Information- Compact, coordinated timelines and timedense displays series graphs with traditional text, tables.
Visual view Users specify view logic by drawing and
authoring configuring hierarchical flow charts.
Testing and Desktop application lets users test and
debugging debug view definitions and upload them to
the server.
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Key Questions
Effectiveness How should we design patient views to
enable effective and efficient data review
by clinicians?
Feasibility What software tools and processes can
enable practical design and
development of large libraries of views?
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Cardiac View (ICDB)
Module
Graph
Reference ranges
Show/hide
module
roll over  short text notes
mouse click  html detail
Timeline
high
in normal range
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Diabetes View (ICDB)
Datetime reference line
Reference value
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Selecting a timestamped note
draws a datetime
reference line
Normal range / grid lines
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Hypertension View (ICDB)
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
DataMontage mockup
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
IPDRA Architecture
View Generation
View Authoring
View authoring tool
(SimBionic)
View logic
specifications
Object templates
(DataMontage XML,
HTML, SQL queries)
View test/debug application
or
Web application server
SimBionic run-time system
Primitive functions:
query database
DataMontage API
generate HTML, XML
DoD Clinical database
(ICDB, M2, CHCS II)
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
View files:
HTML, XML
IPDRA View Authoring Tool (SimBionic)
Catalog of flow charts,
primitive functions, variables
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant
Flow-chart
drawing area
IPDRA Status
• Prototyped IPDRA view server and
test/debug application
• Developed initial set of views using ICDB
• Evaluation and refinement of views planned
for fall 2004 using DoD M2 clinical database
• IPDRA subsystems released as products
• Java SimBionic visual authoring tool (Feb 2004)
• DataMontage graph library (Sept 2004)
AMIA MedInfo 2004 - An Intelligent Patient Data Review Assistant