Fusing a systematic and a case-based repository for medical decision support.

In order to take full advantage of computer-based decision support in clinical practice, it makes sense to combine systems which support the same subject, but contribute to this task in different ways. At the Technical University of Munich, a Combined Clinical Decision Support System (C-CDSS) of this kind has been designed for gastroenterologists. The main goal of the system is to help the physicians in finding information which is relevant for making the right diagnoses or applying the proper therapy to his patients. To achieve this goal, not only systematic knowledge of the medical domain, but also case-based data is useful for a comparison of the actual case with well-documented similar cases of colleagues. The systematic knowledge comprises state-of-the-art textual information and selected multimedia contents in the sense of a standard textbook. The case-based information includes practice-related information on a pool of anonymized cases from clinical routine and also demonstrations of new techniques. By integrating these information resources into one service via a rule-based retrieval system, a powerful decision support system can be generated.

A new approach for integration of telemedicine applications into existing information systems in healthcare.

In order to take the full advantage of telemedicine applications, they must seamlessly be integrated into healthcare services and their information systems (e.g. HIS, POS, RIS). In our approach an HL7/XML-based integration module is used 1) to exchange documents with information systems; 2) to generate and administer documents internally; 3) to present documents. The module fills in pre-defined CDA-conforming XML templates with data from HL7 V2 messages. The approach is first applied to the teleconsultation service EST in the project ENDOTEL.

Telelearning in ophthalmology.

The virtual ophthalmic clinic has been developed to provide an interactive learning platform within the correspondence courses of the Virtual University of Bavaria. It presents clinical case examples from ophthalmology. Basic concepts are a case-based learning dialogue (didactics), peer reviewing (quality), role-based access (organization) and thin web clients (availability). The following requirements had to be fulfilled: Best possible accessibility for students, authors and reviewers; learning control function; comfortable management. The application architecture is based on a relational data base, a ColdFusion (Allaire, Newton, MA, USA) web application server, a standard web server. So far, the application was used in four terms of the virtual university.