Browsing by Subject "Medical Logic Modules"
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Item Data visualization for truth maintenance in clinical decision support systems(2015-06-19) Liu, Gilbert C.; Odell, Jere D.; Whipple, Elizabeth C.; Ralston, Rick K.; Carroll, Aaron E.; Downs, Stephen M.Background and objectives The goal is to inform proactive initiatives to expand the knowledge base of clinical decision support systems. Design and setting We describe an initiative in which research informationists and health services researchers employ visualization tools to map logic models for clinical decision support within an electronic health record. Materials and methods We mapped relationships using software for social network analysis: NodeXL and CMAP. We defined relationships by shared observations, such as two Arden rules within medical logic modules that consider the same clinical observation, or by the presence of common keywords that were used to label rules according to standardized vocabularies. Results We studied the Child Health Improvement through Computer Automation (CHICA) system, an electronic medical record that contains 170 unique variables representing discrete clinical observations. These variables were used in 300 medical logic modules (MLM's) that prompted health care providers to deliver preventive counseling or otherwise served as clinical decision support. Using data visualization tools, we generated maps that illustrate connections, or lack thereof, between clinical topics within CHICA's MLMs. Conclusions The development of such maps may allow multiple disciplines commonly interacting over EMR platforms, and various perspectives (clinicians, programmers, informationists) to work more effectively as teams to refine the EMR by programming logic routines to address co-morbidities or other instances where domains of medical knowledge should be connected.Item Enhancing research on a clinical decision support and geographic information system: getting involved as informationists(Midwest Chapter, Medical Library Association, 2013-10-07) Whipple, Elizabeth C.; Ralston, Rick K.; Odell, Jere D.; Zimmerman, Carly; Liu, Gilbert C.In 2012, the National Library of Medicine (NLM) funded its first ever administrative supplement for informationists. The purpose of these grants is to enhance multidisciplinary basic and clinical research by integrating information specialists (informationists) on research teams in order to improve the capture, organization, and management of biomedical research data. Three informationists at the Indiana University School of Medicine were awarded one of these supplements to work on the Child Health Improvement through Computer Automation (CHICA) system. CHICA is a computer decision support system that interfaces with existing electronic medical record systems (EMRS) and delivers "just in time" patient-relevant guidelines to physicians during the clinical encounter. CHICA-GIS integrates a geographic information system (GIS) with CHICA to refer pediatricians and parents to relevant health services (as needed, for physical activity, dental care, or tutoring) near the patient's neighborhood. The informationists are enhancing the CHICA-GIS system by: improving the accuracy and accessibility of information, managing and mapping the knowledge which undergirds the CHICA-GIS decision support tool, supporting community engagement and consumer health information outreach, and facilitating the dissemination of new CHICA-GIS research results and services. This paper describes the initial process for approaching and collaborating with researchers, writing the grant and getting funded, and progress on the project goals to date.Item Getting off obesity island: how informationists can enhance clinical decision support(Medical Library Association, 2014-05-19) Odell, Jere D.; Ralston, Rick K.; Whipple, Elizabeth C.Clinical decision support (CDS) will play a key role in improving the health of patients; informationists can support the development of CDS systems by indexing rule libraries and mapping the system logic. This work can help rule developers make more informed choices and understand how rules are related conceptually and operationally. With a map, rules can be written to bridge isolated concepts (islands) and rules that are no longer needed can be weeded. Here we explore the added value that informationists bring to projects by reporting on the role of informationists working on a pediatric CDS.Item Mapping the rules: conceptual and logical relationships in a system for pediatric clinical decision support(2013-10-07) Ralston, Rick K.; Odell, Jere D.; Whipple, Elizabeth C.; Liu, Gilbert C.The Child Health Improvement through Computer Automation (CHICA) system uses evidence-based guidelines and information collected in the clinic and stored in an electronic medical record (EMR) to inform physician and patient decision making. CHICA helps physicians to identify and select relevant screenings and also provides personalized, just-in-time information for patients. This system relies on a database of Medical Logic Modules (MLMS) written in the Arden Rules syntax. These MLMs store observations (StorObs) during the clinical encounter which trigger potential screenings and preventive health interventions for discussion with the patient or for follow up at the next visit. This poster shows how informationists worked with the CHICA team to describe the MLMs using standard vocabularies, including Medical Subject Headings (MeSH) and Logical Observation Identifiers Names and Codes (LOINC). After assigning keywords to the database of MLMs, the informationists used visualization tools to generate maps. These maps show how rules are related by logic (shared StorObs) and by concept (shared vocabulary). The CHICA team will use these maps to identify gaps in the clinical decision support database and (if needed) to develop rules which bridge related but currently isolated concepts.