ABSTRACT
Users of drug information typically focus their attention at different levels of description in different situations, such as medication ordering or dispensing. Computer systems utilizing drug information to support such activities must accommodate these multiple perspectives. This paper presents an approach to conceptualizing drug descriptions at multiple levels and outlines key features of an underlying information model that can serve as the basis for a concept-oriented medication vocabulary. These features include dose forms, routes of administration, as well as links to multiple drug classification schemes and medical problems. Implementation, standards, and maintenance issues related to the model are also discussed.
Subject(s)
Pharmaceutical Preparations/classification , Vocabulary, Controlled , Decision Support Systems, Clinical , Drug Administration Routes , Information Theory , Models, Theoretical , Terminology as TopicABSTRACT
Traditional monolithic healthcare information systems (HIS) no longer meet the requirements of today's distributed enterprises and the rapidly changing healthcare environment. The ability of applications to communicate, interpret, and act intelligently upon complex healthcare information has assumed paramount importance. The future lies in the development of flexible component-based architectures that can operate seamlessly within the workflow of a healthcare environment. A key design goal is "graceful degradation," i.e., providing the best decision support possible within the context of available patient data. The First DataBank Drug Toolkit is used as a case study. Several technical challenges associated with building truly plug and play components are discussed.
Subject(s)
Artificial Intelligence , Drug Therapy, Computer-Assisted , Hospital Information Systems , Medical Records Systems, Computerized , Decision Making, Computer-Assisted , Expert Systems , Hospital Information Systems/organization & administration , HumansABSTRACT
Historically, many healthcare information systems (HIS) have been designed around monolithic architectures that rely upon a single organization to provide most, if not all, of the system's business logic. Recent advances in distributed systems technology and healthcare standards make a component-based architecture feasible in building today's HIS. The First DataBank Drug Toolkit is used as a case study for the role of components in the design of a HIS. Several technical challenges associated with building truly plug and play components are discussed.
Subject(s)
Clinical Pharmacy Information Systems , Database Management Systems , Systems Integration , California , Drug Therapy, Computer-Assisted , Humans , Pharmacopoeias as TopicABSTRACT
We report on a joint development effort between ALLTEL Information Services Health Care Division and IBM Worldwide Healthcare Industry to demonstrate concurrent clinical decision support using Arden Syntax at order-entry time. The goal of the partnership is to build a high performance CDS toolkit that may be easily customized for multiple health care enterprises. Our work uses and promotes open technologies and health care standards while building a generalizable interface to a legacy patient-care system and clinical database. This paper identifies four areas of design challenges and solutions unique to a concurrent order-entry environment: the clinical information model, the currency of the patient virtual chart, the granularity of event triggers and rule evaluation context, and performance.
