Design of Decision Support Interventions

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on August 21, 2013

Medication safety screening, as I have written about at length previously, has the potential to reduce prescribing errors and therefore to improve patient safety. I have also previously described alert fatigue, which occurs when the signal:noise ratio is so low that providers start to ignore the alerts. Design of clinical decision support (CDS) systems is therefore a critical factor in order to optimize the impact of these systems on patient care. Read further >

Health eDecisions Use Case 1 Pilot Wraps Up

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on July 17, 2013

The Health eDecisions (HeD) Use Case 1 pilot program wrapped up this week. This federal (US) initiative is working on identifying, defining and harmonizing standards for shareable clinical decision support (CDS). Please see my previous blog post on this topic for additional background on the initiative. Use Case 1 deals with standards to structure medical knowledge in a shareable and executable format. In particular, it defines a harmonized XML schema for rules, order sets and documentation templates. This schema was piloted over the last few months by a variety of content and electronic health record vendors. For example, Wolters Kluwer participated by providing a clinical documentation template for urinary tract infections in the HeD format, which was then successfully converted to a format that could be used by the Veterans Health Administration (VA). Read further >

Mining for Drug Information

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on April 08, 2013

In a typical electronic health record (EHR), patient data are entered and stored using some combination of structured data (e.g. diagnosis codes) and free text. In general, analyses of EHR data focus on the structured data portion, which can be leveraged more easily by standard query tools, and which avoids some of the problems with free text, such as ambiguous terms and negation. Still, there’s a lot of useful information buried in the free text portions of these records. If there were some way to mine the free text, gold might well be discovered. Read further >

Industry Insights from Patents and Patent Applications

John Barker
Written by John Barker
on March 04, 2013

Patents and patent applications are a key source of insights into how professional consumers of content will interact with tax, legal, regulatory and health-related information in the future. I regularly consult patents and patent applications from free sites to gain such insight. In this post, I’ll share with you some of the sites I visit, some of the insights I find interesting, and some of the strategies I use to track patents and patent applications of interest. Read further >

The Use of Chimpanzees in Medical Research

Danielle Capilla
Written by Danielle Capilla
on February 06, 2013

In 2010, the European Union banned the use of chimpanzees in medical research, following the lead of New Zealand, Japan and Australia. Chimpanzees, which are used in biomedical research, have been especially important for scientists studying monoclonal antibodies, Hepatitis C, and cognition. Recently however, the United State’s National Institutes of Health agreed to significantly reduce the number of chimpanzees used in medical research, after finding that most chimp-based studies are unwarranted. Prior to the ban, no chimps had been used in an European Union facility since 1999. Read further >

The Growing Role of Traditional Chinese Medicine

Martin Glauber
Written by Martin Glauber
on January 31, 2013

Describing something as “traditional” can often give one the impression that it is a remnant of the past that is quaint or interesting, but not really a part of modern culture or inferior to mainstream options. In China, Chinese Medicine is not qualified as being “traditional.” You could certainly say that it has earned that title because of its long history, but don’t be misled; it is still very prevalent today. In 2011, there were 361 million times treatment was given to a person at a Chinese Medicine hospital, and the trend is for it to continue growing in popularity. [1] Read further >

Infobuttons for 2013

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on January 24, 2013

Regular readers of this blog will know that I frequently comment on the Health Level Seven International (HL7) Infobutton standard. Infobuttons are context-sensitive links from electronic health records (EHRs) to knowledge resources. Infobuttons were included in the 2014 EHR certification criteria (United States) under both clinical decision support (CDS) and patient education. Read further >

Health eDecisions: A New Standard?

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on December 17, 2012

The medical informatics community has been trying to create a widely adopted standard for clinical decision support (CDS) artifacts for decades. While various standards do exist (e.g. Arden Syntax and GELLO), they haven’t been widely adopted. Perhaps the existing standard of greatest prominence is the Arden Syntax, which was the result of an informatics retreat in 1989 at the Arden Homestead in Harriman, NY. The Arden Syntax became an ASTM standard in 1992 and a Health Level Seven (HL7) standard in 1999. It has been adopted by a few of the major electronic medical record (EMR) vendors, but certainly not by all of them. Moreover, Arden suffers from what is known as the curly braces problem. The institution-specific portion of data retrieval is contained within curly braces, so institutions have to modify the content of the curly braces in order to be able to use Arden rules from external sources. Read further >

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