Standardized problem list generation, utilizing the Mayo canonical vocabulary embedded within the Unified Medical...

Area of Science:

• Medical Informatics
• Clinical Terminology
• Health Information Systems

Background:

• The Mayo problem list vocabulary is a clinically derived lexicon developed from Mayo Clinic's Master Sheet Index and problem list entries.
• The vocabulary was refined by removing redundancies, including lexical variants, spelling errors, and administrative qualifiers.
• Qualifiers are dynamically re-coordinated with terms to enhance the system's recognition of input strings.

Purpose of the Study:

• To assess the viability of a standardized problem entry mechanism through a usability trial.
• To evaluate clinician satisfaction with the system's performance, including diagnosis retrieval and response time.
• To gather feedback on desired system features for improved user experience.

Main Methods:

• The Problem Manager system was implemented using Windows tools and Object Pascal, communicating with a UNIX-based vocabulary server via HTTP.
• A usability trial involved eight clinicians performing eleven scenarios to assess system performance.
• Clinician responses were observed, videotaped, and tabulated to analyze satisfaction and system effectiveness.

Main Results:

• Clinicians successfully found acceptable diagnoses in 91.1% of scenarios.
• The system's response time was acceptable in 92.5% of scenarios.
• Seven out of eight participants found the presentation of related terms useful; all desired shortcuts like abbreviations and word completion.

Conclusions:

• Clinicians are amenable to selecting canonical terms from suggested lists rather than using their own wording.
• There is a demand for "intelligent" systems that suggest terms within categories, such as types of "Migraine".
• The system is functionally usable in its current development stage, and clinicians recognize the value of standardized problem encoding for research, education, and practice.