Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of...

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?

World Wide Web(The Hyperdocument)

InformationResources

Biblio-graphic

Database

Textbook

ExpertSystem

CommunityPractitioner

One-Touch Information Shopping

InformationResources

World Wide Web(The Facilitator)

Biblio-graphic

Database

Textbook

ExpertSystem

CommunityPractitioner

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

?MRSA

Information for Decision-Making

Intelligent Decision Support

Intelligent Decision Support

Query

MRSA

Intelligent Decision Support

?

Result

!

MRSA

Intelligent Decision Support

Obstacles

MRSA

Obstacles

UnderstandInformation

Needs

1MRSA

Obstacles

Get InformationFrom EMR

UnderstandInformation

Needs

1

2

MRSA

Obstacles

Get InformationFrom EMR

ResourceSelection

UnderstandInformation

Needs

1

2

3

MRSA

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

UnderstandInformation

Needs

1

24

3

MRSA

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

UnderstandInformation

Needs

AutomatedTranslation

1

254

3

MRSA

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

QueryingUnderstandInformation

Needs

AutomatedTranslation

1

254

6

3

MRSA

Obstacles

Get InformationFrom EMR

ResourceSelection

ResourceTerminology

Querying

Presentation

UnderstandInformation

Needs

AutomatedTranslation

1

254

6

3

7

MRSA

Integration of Resources

• 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