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Related Experiment Videos

Simulating an integrated critiquing system

M M Kuilboer1, J van der Lei, J C de Jongste

  • 1Department of Medical Informatics, Erasmus University Rotterdam, The Netherlands. kuilboer@mi.fgg.eur.nl

Journal of the American Medical Informatics Association : JAMIA
|April 3, 1998
PubMed
Summary

Human reviewers can generate critiquing comments for asthma/COPD electronic medical records. General practitioners (GPs) valued diagnostic comments most, but disagreed with prescription feedback, posing a challenge for future critiquing systems.

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Area of Science:

  • Medical Informatics
  • Clinical Decision Support

Background:

  • Electronic medical records (EMRs) offer potential for clinical decision support systems.
  • Critiquing systems aim to improve the quality of care by providing feedback to clinicians.
  • Integrating such systems into general practitioner (GP) workflows requires careful consideration of feasibility and effectiveness.

Purpose of the Study:

  • To investigate the feasibility and effectiveness of a critiquing system for asthma/COPD.
  • To identify factors influencing the integration of such a system into a GP's information system.

Main Methods:

  • A simulation study was conducted with four reviewers generating critiquing comments and information requests.
  • Three GPs assessed the comments and provided missing information on six electronic medical records of asthma/COPD patients.

Related Experiment Videos

  • GPs' agreement and relevance scores for comments were recorded, along with reasons for unavailable information.

    • Main Results:

    • Reviewers generated 74 critiquing comments, primarily on prescriptions and workplans.
    • GPs valued diagnostic comments most, but showed significant disagreement with prescription comments despite judging them relevant.
    • GPs could provide answers for 64% of information requests, with common reasons for unrecorded data including explicit omission or assumption of common knowledge.

    Conclusions:

    • Human reviewers can generate actionable comments from existing EMR data for asthma/COPD.
    • A discrepancy exists between GPs' perceived relevance and agreement with prescription-related comments.
    • The study favors the development of an integrated, non-inquisitive critiquing system due to challenges in presenting feedback and limited impact of requested information.