Post on 20-Dec-2015
transcript
Overview
• History (Medline Button and Infobuttons• Architectural Overview of the Infobutton Manager• Demo (WebCIS and Eclipsys)• How Infobutton Manager links work• Terminology Issues• Integrating with clinical systems• How can I play?
Infobutton Manager Architecture
Context
ContextMatching
QuestionSelection
Instantiation
Links
Infobutton Manager
Context Table
Question Table
Resolving Clinician Information Needs
InformationNeed TriggeredBy Clinical Data
1
ExtractContext Data
2
ContextMatching
3
QuestionSelection
4
Presentation ofQuery Results
7
PresentationOf Questions
5
Query aResource
6
Infobutton Manager Infobutton
How Infobutton Manager Links Work
• Simple link• Concept-based link• Simple search• Concept-based search• Intelligent agent• Calculator
• Match concept of interest to class(es)
• Identify context based on class(es)
• Retrieve question(s) for context
• Sort by “priority”
• Return HTML page of links (URLs)
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
• Question has “hardcoded” URL
e.g.: “www.columbia.edu/potassium.pdf”
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
• Translate concept of interest to controlled term
• Find controlled term in data dictionary
• Obtain term attribute for constructing URL from data dictionary
• Construct URL, e.g.: www.columbia.edu/lab/<>.html
+ cl001900 . www.columbia.edu/lab/cl001900.html
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
Insert concept of interest into CGI function call as a parameter
e.g.: www.Uptodate.com/search.cgi?term=<>+ POTASSIUM .www.Uptodate.com/search.cgi?term=POTASSIUM
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
• Translate concept of interest to controlled term
• Obtain term translation from data dictionary
• Insert translated term into CGI function call as a parameter
e.g.: pubmed.gov/search.cgi?term=<>[MeSH+Terms]+
Potassium .
pubmed.gov/search.cgi?term=Potassium[MeSH+ Terms]
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
• Resource is not a simple document or search CGI
• Log-on, navigation or other interaction required
• Multiple context parameters used
• Agent:- parses context parameters- interacts with resource- parses results- presents summary- may modify links
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
• No resource available
• Interaction too complex
• Create self-contained agent:- parses context parameters- constructs Web page- presents results - may have Infobuttons of its own
How Infobutton Manager Links Work
• Simple link• Concept-based
link• Simple search• Concept-based
search• Intelligent agent• Calculator
The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol
• First, I have to find the guidelines
The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol
• First, I have to find the guidelines
• Then I have to add the question to the IM table
The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table
• Finally, I link the question to the context…
The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table• Finally, I link the question to the context…
• … and I’m done - about 15 minutes.
“GET” Method:
<a href=“flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi? Info_institute=CPMC&info_med=1560&info_context=LabDetail”> <img info.gif\"></a>
- OR -“POST” Method:<form method="POST" TARGET="INFO" NAME="INFO" action="flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="info_med" value="1560"><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name=“DOB" value="1951-05-26"><input type="HIDDEN" name=“info_age" value=“52"><input type="HIDDEN" name=“info_sex" value="F"><input type="HIDDEN" name=“info_usertype" value=“MD"><input type="HIDDEN" name=“info_mrn" value="3131313"><input type="HIDDEN" name=“info_user" value="ciminoj"><input type="HIDDEN" name="info_other" value="1560|6.8|10.0-20.0|mg/l|1559|29.7|20.0-40.0|mg/l|"></form>
Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “14877-5” (the LOINC Code) and “PHENYTOIN”.
How can I play?
• Can your system evoke a Web browser?
• Can you customize the URL?• Decide what information needs you have
• Decide how you want to address the needs
“GET” Method:
<a href=“flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi? Info_institute=CPMC&info_med=1560&info_context=LabDetail”> <img info.gif\"></a>
- OR -“POST” Method:<form method="POST" TARGET="INFO" NAME="INFO" action="flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="info_med" value="1560"><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name=“DOB" value="1951-05-26"><input type="HIDDEN" name=“info_age" value=“52"><input type="HIDDEN" name=“info_sex" value="F"><input type="HIDDEN" name=“info_usertype" value=“MD"><input type="HIDDEN" name=“info_mrn" value="3131313"><input type="HIDDEN" name=“info_user" value="ciminoj"><input type="HIDDEN" name="info_other" value="1560|6.8|10.0-20.0|mg/l|1559|29.7|20.0-40.0|mg/l|"></form>
Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “14877-5” (the LOINC Code) and “PHENYTOIN”.
Infobutton Manager Parameters
How can I play?
• Can your system evoke a Web browser?• Can you customize the URL?• Decide what information needs you have• Decide how you want to address the needs
• Address the terminology issue
Automated Retrieval with Clinical Data
UnderstandInformation
Needs
1
Get InformationFrom EMR
2
AutomatedTranslation
5
ResourceTerminology
4
Presentation
7ResourceSelection
3
Querying
6MRSA
How can I play?
• Can your system evoke a Web browser?• Can you customize the URL?• Decide what information needs you have• Decide how you want to address the needs• Address the terminology issue
• Coordinate with me
<a href="Javascript:get_info('35702')"><img src="info.gif"></a>
function get_info(mc){ var infowin = window.open("","INFO"); infowin.focus(); document.INFO.info_med.value=mc; document.INFO.submit(); }
<form method="POST" name=“INFO” action="wc_infomanage.cgi"><input type="HIDDEN" name="info_med" value=""><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="DOB" value="1951-05-26"><input type="HIDDEN" name="SEX" value="F"><input type="HIDDEN" name="USER" value="ciminoj"></form>