Just-in-time Decision-Support for Improving and Optimising Professional Practices
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Transcript of Just-in-time Decision-Support for Improving and Optimising Professional Practices
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Just-in-time Decision-
Support for Improving and
Optimising Professional
Practices
Prof. Antoine Geissbühler, MD
Geneva University Hospitals
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1999: to err is human
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Han
et
al., P
edia
tric
s 2
00
5;1
16:1
50
6-1
512
2005: e-iatrogenesis
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Meaningful integration in the care
processes
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Geneva University Hospitals
• 2'200 beds
• 3 campuses, 30 smaller sites
• Primary, secondary and
tertiary care
• 50'000 admissions/year
• 800'000 outpatient visits/year
• 10'000 collaborators
• 1‘500 physicians
• 3'500 nurses
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Considering today'sserum creatinine level, I recommend that youadjust the dosage of intravenous gentamicinto 80mg every 24 hours(and check its bloodlevel in three days)
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Supporting care production
• Electronic health record
• CPOE and clinical decision-support tools
• Collaborative care pathways
• Health information exchanges & telemedicine
Learning from care
data• Information collection, aggregation
• Knowledge discovery
• Population-level surveillance
Activating new
knowledge
• Knowledge validation and operationalization
• Clinical decision-support tools
• Patient simulators
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decisions,
actions
data,
signals
information,
knowledge
integration,
interpretation
A "learning institution"
just in time
at the point
of care
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decisions,
actions
Patient record
- visualisation
- data capture
- links to KB
Provider
order entry,
decision
supportCare planning
and
documentation
Institutional
knowledge
management:
- creation
- validation
- distribution
Knowledge
discovery,
data mining
Alerts and
notifications
data,
signals
information,
knowledge
integration,
interpretation
Scheduling and
optimization
A "learning institution"
just in time
at the point
of care
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Integrating information
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From documentation to coordination
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Collaborative care: clinical pathways
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Connecting with the real world
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Driving decisions with clinical data
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Discovering knowledge: @neurIST
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DEBUG-IT