Development and Evaluation of a Prototype of a Learning Electronic Medical Record System (King) / Supporting the Implementation of Clinical Practice Guidelines - The Story of the CoPILoT Project (Camacho)
Andrew King - Electronic medical records (EMRs) are capturing increasing amounts of data per patient. For clinicians to efficiently and accurately understand a patient’s clinical state, better ways are needed to determine when and how to display EMR data. We built a prototype system that records how physicians view EMR data, which we used to train models that predict which EMR data will be relevant in a given patient. We call this approach a Learning EMR (LEMR). A physician used the prototype to review 59 intensive care unit (ICU) patient cases. We used the data-access patterns from these cases to train logistic regression models that, when evaluated, had AUROC values as high as 0.92 and that averaged 0.73, supporting that the approach is promising. A preliminary usability study identified advantages of the system and a few concerns about implementation. Overall, 3 of 4 ICU physicians were enthusiastic about features of the prototype.
Jhon Camacho - There is a recognized gap between what research has shown as effective and what clinicians do in their day-to-day practice. All around the globe, countries spend a large amount on resources trying to close this gap. Among these efforts, the processes of construction and dissemination of clinical practice guidelines play significant roles. The traditional approach to disseminate these guidelines has been through the publication of documents either on paper or on the Internet. However, several investigations have shown the lack of effectiveness of this approach, resulting in a very low percentage of clinical practice guidelines followed regularly. Among the recommendation included in a typical clinical practice guideline, the decision-making procedures are probably the most difficult to understand and therefore, to implement in the regular practice. I this talk, we present preliminary results of the CoPILoT (Clinical PractIce guideLines Tools) project, which aims at developing methods to facilitate the dissemination and implementation of procedural recommendations contained in clinical practice guidelines.