Transcript HeartCare, Web-Based Support for CABG-Patients

HeartCare, Web-based Home
Support for CABG-patients
Background and Significance
Changes in healthcare impact
discharge teaching
Patient-specific health information
is available on the WWW
Features
 Providing health information graduated to patient’s
stage of recovery and tailored to his/her medical
profile and individual needs
 Capitalizing
on the interactive technology and
health-oriented web sites to extend discharge
teaching
Design HeartCare: Database
Design HeartCare

Filtered set of cardiac recovery resources
available on the web and self constructed web
pages are stored in an Access© database.
Web pages are described with index terms
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Index terms are also used to describe the medical
profile
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Matching algorithm web page – patient
Indexing Web Pages in HeartCare
Nurse-clinicians tagged web documents
with:

Selected concepts from Medical Language
Subject Heading (MeSH), a class of
Knowledge Representation Models
for bio-medicine
 Supplemented with terms reflecting local
clinical practice
Example of Indexing
http://www.women.americanheart.org/physicians/sub_content/ten.html
tagged with the terms “diet “and “weight” is pulled
4 different times for the menu heading “Ten questions
a woman should ask her healthcare provider”
http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/calccb
.html
with terms “Beta Blockers/Calcium Channel
Blockers” and “Medications” are pulled for all
conditions that have the subject heading assigned,
even when not applicable
Implications for Retrieval
Issues:
(1) too many pages pulled per patient
(2) too many duplicate pages
(3) some pages were pulled that did not
exactly match the patient profile.
Examples of Total Web Pages in
Combination with Menu title Retrieved
for a Patient
Patient
patient 1
Combinations Unique
Retrieved
Combinations
266
138
patient 2
891
647
patient 3
324
281
patient 4
584
203
Example of duplicate page retrieval for a Patient: Web Page
http://rex.nci.nih.gov/NCI_Pub_Interface/Clearing_the_A
ir/clearing.html, keywords smoking and behavior changes
Menu Title

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Taking charge of your health - Week
3-6
Taking charge of your health - Week
3-6
Taking charge of your health - Week
3-6
Beginning lifestyle changes - Week 712
Beginning lifestyle changes - Week 712
Beginning lifestyle changes - Week 712
Changing your lifestyle - Week 13-26
Changing your lifestyle - Week 13-26
Changing your lifestyle - Week 13-26
Condition

Diabetes
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Hypertension
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Smoking
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Hypertension

Smoking

Diabetes
Diabetes
 Hypertension
 Smoking
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Pages Retrieved that Does not
Match the Patient’s Profile
Sample Male Patient with Risk Factors
Hypertension and Stress
– 11 different pages relating to the risk of smoking
and smoking cessation
– 8 web pages relating to risk factors for women
– 5 pages specific about being overweight and
weight loss
– 2 pages on the topic of diabetes management
Discussion

Flawed indexing system

Conceptualization problem

Lacking structure of index terms
This study is supported by NLM/NINR Grant
LM06249, Principal Investigator Dr. P.F.
Brennan
The authors want to thank the members
from the HeartCare team for their advice
and support.