Partitioning Knowledge Bases between Advanced Notification and Clinical Decision Support Systems

Ephemeral medical administrative knowledge is substantially different from comparatively enduring clinical knowledge. The functional partition of such administrative knowledge in dedicated decision support systems (DSS), separate from clinical knowledge, provides many advantages. Classically, however, clinical event monitors and the syntax for their logic modules include the coding of notifications (e.g. Arden Syntax). The following paper will describe the rationale for segregating policies, user preferences and clinical monitoring rules. It will detail the implementation of knowledge bases partitioned between an advanced notification DSS and a clinical DSS, which together form a novel and complex clinical event communication service. In this communication service, notification rules are abstracted from care-provider roles, hospital policies are abstracted from alerting mechanisms, and user-defined preferences determine which devices are to be used for receiving alert notifications. Our prototype service operates from a clinical event monitor through a secure notification service proxy to the BlackBerry™ Personal Digital Assistant (PDA)/phone device over the Nextel cellular network. Our design differs from previous notification systems in that it integrates an advanced and versatile notification platform supporting a wide range of mobile devices with a sophisticated XML/HL-7 compliant communication protocol. This protocol includes advanced notification attributes, detail and context in managing provider roles, schedules, institutional policies, personal preferences and acknowledgments.

By: Yves Lussier, Rose Williams, Srikant Jalan, Tara Borlawsky, Jianrong Li, Edie Stern

Published in: RC23402 in 2004


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