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Implementation of a computerized patient advice system using the HELP clinical information system.

D F Sittig1, N L Pace, R M Gardner

  • 1Department of Medical Informatics, LDS Hospital/University of Utah, Salt Lake City 84143.

Computers and Biomedical Research, an International Journal
|October 1, 1989
PubMed
Summary

A computerized patient advice system (COMPAS) demonstrated feasibility in directing respiratory therapy for intensive care unit (ICU) patients with adult respiratory distress syndrome. The system successfully provided recommendations, with clinicians accepting most suggestions.

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Area of Science:

  • Medical Informatics
  • Critical Care Medicine
  • Artificial Intelligence in Healthcare

Background:

  • Adult respiratory distress syndrome (ARDS) requires complex, real-time respiratory therapy management in intensive care units (ICUs).
  • Clinical decision support systems can potentially optimize patient care and resource utilization in critical care settings.

Purpose of the Study:

  • To evaluate the feasibility of the Computerized Patient Advice System (COMPAS) for directing respiratory therapy in ICU patients with ARDS.
  • To assess the performance of a blackboard control architecture within a clinical information system for managing mechanical ventilation.

Main Methods:

  • Development of the COMPAS using the HELP clinical information system with a modified blackboard control architecture.
  • Expert clinicians defined decision logic and actions for five ventilatory support modes.

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  • Clinical staff utilized COMPAS to manage ventilatory support for five ICU patients over 624 hours.

    • Main Results:

    • COMPAS generated therapy suggestions in 379 out of 407 (93.1%) decision-making opportunities.
    • Clinical staff accepted COMPAS's recommendations in 320 out of 379 (84.4%) instances.
    • The system facilitated management of ventilatory support for critically ill patients.

    Conclusions:

    • The study suggests that a clinical information system employing a blackboard control architecture is feasible for managing ventilatory support in severely ill ICU patients.
    • COMPAS shows promise as a tool to aid clinicians in respiratory therapy decision-making for ARDS patients.