Use, Usability, Usefulness and Impact of an Infobutton Manager
The Librarian Infobutton Tailoring Environment (LITE)
description
Transcript of The Librarian Infobutton Tailoring Environment (LITE)
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The Librarian Infobutton Tailoring Environment
(LITE)
James J. Cimino
National Institutes of Health and Columbia University
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Today’s Topics
• Clinician Information Needs• Infobuttons• Infobutton Managers• The Coumadin Story• Institution-Specific Requirements• Infobutton Manager Customization Tasks• Librarian Infobutton Tailoring Environment
– Research plan– Initial efforts– Getting involved
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Health Knowledge for Decision Support
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Infobuttons
Anticipate Need and Provide Queries
i
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Information Needs of CIS Users
• Common tasks may have common needs
• System knows:– Who the user is– Who the patient is– What the user is doing– What information the user is looking at
• We can predict the specific need
• User is sitting at a computer!
• We can automate information retrieval
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First Attempt: The Medline Button
• CIS on mainframe
• BRS/Colleague (Medline) on same mainframe
• Get them to talk to each other
• Search using diagnoses and procedures
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First Attempt: The Medline Button
• CIS on mainframe
• BRS/Colleague (Medline) on same mainframe
• Get them to talk to each other
• Search using diagnoses and procedures• Technical success
• Practical failure
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Education at the Moment of Need
MRSA
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Education at the Moment of Need
UnderstandInformation
Needs
1MRSA
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Education at the Moment of Need
Get InformationFrom EMR
UnderstandInformation
Needs
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2
MRSA
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Education at the Moment of Need
Get InformationFrom EMR
ResourceSelection
UnderstandInformation
Needs
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2
3
MRSA
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Education at the Moment of Need
Get InformationFrom EMR
ResourceSelection
ResourceTerminology
UnderstandInformation
Needs
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24
3
MRSA
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Education at the Moment of Need
Get InformationFrom EMR
ResourceSelection
ResourceTerminology
UnderstandInformation
Needs
AutomatedTranslation
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254
3
MRSA
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Education at the Moment of Need
Get InformationFrom EMR
ResourceSelection
ResourceTerminology
QueryingUnderstandInformation
Needs
AutomatedTranslation
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254
6
3
MRSA
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Education at the Moment of Need
Get InformationFrom EMR
ResourceSelection
ResourceTerminology
Querying
Presentation
UnderstandInformation
Needs
AutomatedTranslation
1
254
6
3
7
MRSA
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Research Issues
• What are the information needs?
• Which context information is important?
• What resources can satisfy needs?
• How can retrieval be automated?
– What context data are used?
– How are the data translated?
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Infobuttons vs. Infobutton Manager
Pageof
Hyperlinks
InfobuttonClinical System Resourc
e
InfobuttonManager
ContextQuery
KnowledgeBase
s
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The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol
• First, I have to find the guidelines
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The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol
• First, I have to find the guidelines
• Then I have to add the question to the IM table
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The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table
• Finally, I link the question to the context
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The Coumadin Story
• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table• Finally, I link the question to the context
• Voilá!
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Usage in Lab Contexts
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HR-LabDetail
IM-LabDetail
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Usage in In-Patient Drug Contexts
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HR-InPatientDrugs
IM-InPatientDrugs
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Usage in Diagnosis Context
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HR-Diagnoses
IM-Diagnoses
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Usage in Lab Order Entry Context
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HR-LabOrder
IM-LabOrder
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Usage in InPat Drug Order Entry
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HR-DrugOrder
IM-DrugOrder
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Institution-Specific Requirements
• What are the users’ information needs?
• In what contexts do those needs arise?
• What resources will resolve the needs?
• Terminology????????
• How can the Infobutton Manager be integrated into the clinical information system?
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New York Presbyterian Hospital (Eclipsys)
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NY Office of Mental Health (Psykes)
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NY Office of Mental Health (Psykes)
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Regenstrief Medical Record System
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Cryststal Run Healthcare (NextGen)
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Infobutton ManagerMaintenance Tool
Functions:Browse
AddUpdateDelete
Clinician
Infobutton Manager
TranslationTable
TermTranslation
ContextTable
ContextMatching
InfobuttonTable
QueryConstruction
Page ofLinks
SystemMaintainer
Institution Customization Tasks
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Institution Customization
• Institution librarians know their clients best
• Institution librarians know their resources
• How can librarians populate Infobutton Manager tables?
• Terminology is institution-specific
• How do we handle institution-specific data translation?
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Librarian Infobutton Tailoring Environrment (LITE)
• Specify user contexts
• Identify terminology in each context
• Information needs in each context
• Resources for resolving information needs
• Automating translation and querying
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Infobutton ManagerMaintenance Tool
Functions:Browse
AddUpdateDelete
Clinician
Infobutton Manager
TranslationTable
TermTranslation
ContextTable
ContextMatching
InfobuttonTable
QueryConstruction
Page ofLinks
SystemMaintainer
Institution Customization Tasks
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LITE TasksLibrarian Infobutton
Tailoring Environment(LITE)
InfobuttonManagerLog File
LITELog File
LITE Auditing
LITE Monitoring
Infobutton ManagerMonitoring
InstitutionLibrarian
ContextDefinition
ResourceUtilization
TerminologySpecification
QuestionConstruction
ResourceSelection
Clinician
Infobutton Manager
TranslationTable
TermTranslation
ContextTable
ContextMatching
InfobuttonTable
QueryConstruction
Page ofLinks
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LITE Research Plan• Conduct community assessment
• Refine LITE features
• Establish forum for feedback from librarians
• Develop LITE in an iterative manner
• Develop a user manual and tutorial
• Evaluate usability of LITE by librarians
• Evaluate the use of LITE
• Disseminate the results of the project
• Promote the use of the IM and LITE
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Initial Efforts
• Drupal site
• Community of users
• Clear through Institutional Review Board
• Enroll “subjects”
• Make each draft a forum topic
• Collect feedback
• Iterate
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Conclusion
• Infobuttons can anticipate and resolve clinicians’ information needs
• Institution-specific tailoring is required• International standard will stimulate wider
adoption• Librarian Infobutton Tailoring Environment
will put the Infobutton Manager on autopilot• Enrollment now open• Demo version of LITE in testing now!
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Acknowledgments
• Jianhua Li• Many student contributors• Guilherme Del Fiol• Noemie Elhadad• National Library of Medicine• NC/NMLG and MLGSC&A
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www.infobuttons.org
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lite.dbmi.columbia.edu