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Arnold Kim

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  • OS28 - Learning to Leverage Technology (ID 33)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/07/2017, 10:30 AM - 12:00 PM, Room 203AB
    • OS28.04 - Fusing Medical Documentation and Order Entry into a Design Platform (ID 265)

      Arnold Kim, Hospitalist, Thunder Bay Regional Health Sciences Center; Thunder Bay/CA

      • Abstract
      • Slides

      Purpose/Objectives: While it can be said that many other professions design: an architect designs a house or an engineer designs an electrical circuit; it sadly cannot be said that health care providers design their patientsÂ’ care plans. The chief tools for creating and implementing patient care planning are classical medical documentation and order entry. There are two main problems with this prior art. Medical documentation is semi-structured and not rigorous enough for non-ambiguous analysis Medical documentation contains the reasoning for orders, but there is no rigorous path to align and validate these important relationships. An evolving research software prototype was constructed and is in active alpha testing in a busy inpatient environment to explore the feasibility and advantages of fusing documentation and orders while keeping their relationships explicit.

      Methodology/Approach: Over the last 5 years, we have used a software modeling approach to create a formal language to represent medical documentation and orders and fuse them into singular model (PCM). Formal languages are a family of languages that are in common use in the engineering industry in the form of programming languages. The strength of these languages is that they eliminate ambiguity and allow the creation of responsive and intelligent editors that can be created to analyze and manage this code. We saw an opportunity to create a sophisticated design tool that is conceptually familiar to other technical professions (especially software engineers). We also saw an opportunity to create a programmable language that can both facilitate and constrain PCMs such that they are in compliance with best practice, local and regional policies. The result is an early generation Patient Care Design Tool (PCDT) which has been undergoing alpha testing over the last 4 years in a very busy medical inpatient environment at TBRHSC (Thunder Bay Regional Health Science Center). We have been gathering feedback in order to advance the PCDT prototype.

      Finding/Results: From the live clinical field, a trained user can construct PCMs using our early generation PCDT under very high clinical workloads and gain significant advantages in speed, accuracy, automation and clarity. Large arrays of automation can be implemented during PCM design and thereafter. These include decision support, error detection, e-learning, background commentary, asynchronous communications, and metrics gathering. Isolated order entry workflows in most cases can be entirely eliminated. This allows care providers to focus entirely on the construction of optimal design of their PCMs for their patients and eliminate the recapitulation and afterthought of CPOE. Additionally, such a system can permit collaborative asynchronous drafting of PCMs to reduce the amount of overhead associated with team collaboration while still allowing maximum participation (Collaborative Patient Care Design: CPCD).

      Conclusion/Implication/Recommendations: Our group is seeking to broaden the discussion and resources in order to advance PCMs as the new platform for patient care planning. We are a research group in search of likeminded academic and industry partners to advance, test and publish to trigger the rise of PCDTs to tame cost, complexity, efficiency and measurability in health care.

      140 Character Summary: The rationale and demonstration of the enormous advantages of fusing medical documentation and order entry into a single model called a Patient Care Model (PCM)

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