Saturday, January 21, 2006

Diagnostic Decision-Support Software

Read the full article, featuring Larry Weed, in the December 8, 2005 Technology Quarterly published in The Economist. (Subscription required.)

Dr. Larry Weed M.D. is a real pioneer in the area of medical knowledge systems. He developed the patient oriented medical record, and eventually started the PKC corporation to develop diagnostic software for doctors to use. This is part of what the Economist says about his software:

"There is simply too much new (medical) information (for doctors) to absorb and retain. Medline, a medical database, indexed 3,672 articles about adult coronary heart-disease studies in 2004, notes Elizabeth McGlynn, of RAND Health, part of the RAND think-tank......

"The PKC software stands apart within the little-known niche of “diagnostic decision-support” software: with other diagnostic aids, doctors generally use software on an as-needed basis, such as during a complex case. But PKC takes patients and health-care providers through a thorough—and documented—question-and-answer routine at each encounter. PKC engages patients, who enter information about symptoms, family medical history and so forth. During or after the medical exam, the health professional enters physical findings and test results. PKC then returns a list of diagnoses and care options to consider, with links to journal articles on which the recommendations are based.

"Doctors who have used PKC for years tell endless tales of improved office efficiencies, better patient involvement and diagnoses that they might otherwise have missed. A study from 2001 validates their experience, indicating that PKC's systematic approach can improve outcomes in chronic conditions such as diabetes. America's Department of Defence has been impressed enough to build PKC into its own Composite Health Care System, called CHCS II, so that Dr Weed's software helps to look after some 9m people. “PKC has a fairly unique capability to bounce a person's health record up against medical literature,” says Colonel Bart Harmon, the army's chief medical information officer. He adds that PKC's list of potential diagnoses and care options are the opposite of the so-called “cookbook” medicine that many doctors fear will result from automation.

"As with POMR, PKC's software has appeal outside America, too. 'I would be very pleased if we could get all the general practitioners in Britain to use his software,' says Brian Jarman, a professor emeritus at London's Imperial College School of Medicine and a former president of the British Medical Association. 'It's virtually impossible for a doctor these days to remember everything. Computers don't let you forget things.'"

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