An Overview of Efforts to Bring Clinical Knowledge to the Point of Care

Abstract

By bringing people the right information in the right format at the right time and place, state of the art clinical information systems with imbedded clinical knowledge can help people make the right clinical decisions. This chapter provides an overview of the efforts to develop systems capable of delivering such information at the point of care. The first section focuses on “library-type” applications that enable a clinician to look-up information in an electronic document. The second section describes a myriad of “real-time clinical decision support systems.” These systems generally deliver clinical guidance at the point of care within the clinical information system (CIS). The third section describes several “hybrid” systems, which combine aspects of real-time clinical decision support systems with library-type information. Finally, section four provides a brief look at various attempts to bring clinical knowledge, in the form of computable guidelines, to the point of care.be sufficiently expressive to explicitly capture the design rational (process and outcome intentions) of the guideline’s author, while leaving flexibility at application time to the attending physician and their own preferred methods.” (Shahar, 2001)