KR20100097522A - Clinical decision support system and method thereby - Google Patents

Abstract

PURPOSE: A clinical decision support system and a method thereof are provided to mix architecture for knowledge with architecture for a clinical decision application, thereby guaranteeing interoperability with scalability. CONSTITUTION: An application operating unit(141) operates a clinical decision support application according to a clinical decision support request. An interface repository(142) stores EMR(Electronic Medical Record) schemas respectively. An interface server(143) searches patient information for clinical decision support. A knowledge repository(145) stores authored knowledge. An inference server(146) searches knowledge for clinical decision support corresponding to the patient information.

Description

Clinical Decision Support System and method

The present invention relates to a clinical decision support system (CDSS), and more particularly, to a clinical decision support system and method in which a knowledge-oriented architecture and an architecture in which a clinical decision application is centered are mixed.

The present invention is derived from research conducted as part of the bioindustrial technology development project of the Korea Health Industry Development Institute and the Seoul National University Industry-Academic Cooperation Foundation. [Task Management No .: A050909, Title: Electronic Health Record Architecture, Integrated Medical Terminology System, Clinical Decision Support System]

In recent years, many medical institutions have stored and managed patient medical records using electronic medical records (EMR) instead of recording patient-related information on paper and film in a traditional manner. Information can be managed easily and exchanged with each other. In addition, with the widespread use of equipment for measuring a patient's health status, patients can easily check their health status even if they do not go to the hospital.

In the meantime, clinical practice guidelines, protocols and critical pathways for quality and patient safety have guided medical staff to apply the best practices in the care process. However, the contents are so vast that it is impossible for the medical staff to remember them all and treat the patients. In addition, there is a limit to the direct use to the individual patient to treat as a general guideline that does not reflect the characteristics of the patient, there is a problem that is not fully utilized because it was not easily accessible at the right time required. As such, it is easier to obtain information about the health status of the patient than in the past, but patients still have difficulty in analyzing the information about the health status. In addition, doctors may need to review additional data to see the health information of various patients and to check the health status of patients. Therefore, a clinical decision support system (CDSS) has been developed that can support the judgment of a patient's health or a patient's health based on information on the patient's health.

The Clinical Decision Support System (CDSS) is a computer-based system designed to help you make more informed decisions through appropriate data, information and knowledge management when you need to make a decision. As healthcare information becomes more in- creased, interest in the main objectives of improving quality, securing safety, and reducing costs is increasing, and the CDSS is an effective means of doing so.

However, in order for the clinical decision support system to be effectively used, it is necessary to express knowledge in a standardized form so that knowledge can be utilized whenever needed, and remove obstacles to expand the clinical decision support service. Based on the results, it is important to continue to improve the relevant knowledge. However, since the existing clinical decision support system establishes and uses a different clinical decision support system for each medical field, when the medical field changes, a new clinical decision support system has to be established. There is a problem that it is difficult to accumulate.

The technical problem to be solved by the present invention relates to a clinical decision support system (CDSS) and method having a knowledge base independent of the hospital information system.

In order to achieve the above object, the clinical decision support system (CDSS: Clinical Decision Support System) according to the present invention, the application driver for driving a clinical decision support application, in accordance with the user's clinical decision support request; An interface repository that stores a standard and an electronic medical records (EMR) schema for each hospital; An interface server that searches for patient information for clinical decision support by referring to the interface repository according to the driving of the application driver; Knowledge authoring section for performing standards-based knowledge authoring for clinical decision support; A knowledge repository for storing knowledge authored by the knowledge authoring unit; And an reference server that searches for knowledge for NDE support corresponding to the patient information retrieved from the interface server by referring to the knowledge repository, and wherein the application driver includes the knowledge retrieved from the reference server. This information is output to the hospital information system of the user as information for clinical decision support.

In order to achieve the above object, the clinical decision support method according to the present invention comprises the steps of driving the clinical decision support application according to the user's clinical decision support request; Retrieving patient information for clinical decision support by referring to an interface repository having a standard and an electronic medical record (EMR) schema for each hospital; Retrieving knowledge for NDE support corresponding to the retrieved patient information by referring to a knowledge repository that stores standards-based knowledge for clinical decision support; And outputting the retrieved knowledge to the hospital information system of the user.

According to the present invention, interoperability and scalability are established because a clinical decision support system is constructed by mixing a knowledge-oriented architecture and an architecture based on a clinical decision application independently of a hospital information system. Can provide a service operating environment with guaranteed portability and reusability.

Hereinafter, the clinical decision support system (CDSS) according to the present invention will be described in detail with reference to the accompanying drawings.

1 is a block diagram of an embodiment for describing a clinical decision support system (CDSS) in accordance with the present invention, including a hospital information system 100, a service interface 120, and a clinical decision support system 140. .

The hospital information system 100 stores and manages a patient's medical record using an electronic medical record (EMR) or the like in order to manage information about a patient's health condition. The hospital information system 100 displays a function selection menu bar on the screen when a user (for example, a doctor or a nurse) requests a clinical decision support service, and when the user selects to execute the service, the clinical decision support system The driving signal for supporting the service is transmitted to the service interface 120.

The service interface 120 is responsible for an interface function for interfacing the services of the hospital information system 100 and the clinical decision support system 140 held by the hospital. Accordingly, when the service interface 120 receives the driving signal from the hospital information system 100, the service interface 120 transmits the received driving signal to the clinical decision support system 140.

The clinical decision support system 140 supports the user to make an accurate decision through appropriate data, information, and knowledge management when a decision is required, when there is a service request from the user. To this end, the clinical decision support system 140 of the present invention includes an application driver 141, an interface repository 142, an interface server 143, a knowledge authoring unit 144, a knowledge repository 145, and an reference server. 146.

When the application driver 141 receives the driving signal from the service interface 120, the application driver 141 drives the clinical decision support application. The clinical decision support application is a unit module that provides clinical decision support services. It provides standard medical guidance (CPG) services, primary clinical pathway (CP) services, and drug interaction services.

The interface repository 142 stores standard and electronic medical record (EMR) schemas for each hospital and information that can be mapped.

FIG. 2 illustrates the detailed components of the interface repository 142 illustrated in FIG. 1 and includes a standard EMR schema storage unit 200, a mapping information storage unit 202, and a location information storage unit 204.

The standard EMR schema storage unit 200 stores a standard electronic medical record schema. The standard electronic medical record schema refers to a generalized data structure for the electronic medical record utilized by the standard knowledge stored in the knowledge repository 145.

The mapping information storage unit 202 stores mapping information of the standard electronic medical record schema stored in the standard EMR schema storage unit 200 and the electronic medical record schema of each hospital. The mapping information is information defining the correlation of the data structure of the electronic medical record of each hospital with respect to the data structure of the standard electronic medical record. The mapping information is edited in the interface server 143 and stored in the mapping information storage unit 202.

The location information storage unit 204 stores location information of the external device for interworking with the external device. In this case, the external device includes various systems linked with the clinical decision support system (CDSS). For example, the hospital information system 100 also belongs to this.

When the application driver 141 is driven, the interface server 142 searches for patient information for clinical decision support by referring to the interface repository 143.

FIG. 3 illustrates the detailed components of the interface server 143 shown in FIG. 1, and includes a data interface editing unit 300, a mapping information converter 302, a query generator 304, and a data interface adapter 306. ).

The data interface editing unit 300 displays mapping information of the standard electronic medical record schema and the electronic medical record schema of each hospital, and edits the mapping information according to a user's selection. The data interface editing unit 300 transmits the edited mapping information to the mapping information storage unit 202 and the mapping information conversion unit 302 of the interface repository 142.

The mapping information converter 302 converts the mapping information edited by the data interface editor 300 to Extensible Markup Language (XML), and outputs the converted mapping information to the query generator 304.

The query generator 304 generates a query accessible to the hospital information system for retrieving patient information by using the mapping information converted by the mapping information converter 302, and sends the generated query to the data interface adapter 306. Output

The data interface adapter 306 transmits the query generated by the query generator 304 to the hospital information system 100 through the service interface 120.

When the hospital information system 100 receives the query from the CDSS, the hospital information system 100 retrieves the patient information stored in the electronic medical record database provided therein and transmits the patient information to the service interface 120. The data interface adapter 306 receives patient information via the service interface 120.

The knowledge authoring unit 144 performs standards-based knowledge authoring for clinical decision support, and outputs knowledge corresponding to the result to the knowledge repository 145.

FIG. 4 illustrates the detailed components of the knowledge authoring unit 144 shown in FIG. 1, and includes a knowledge framework 400, a knowledge designing unit 402, a knowledge converting unit 404, a knowledge viewer 406, and a virtual The execution unit 408 and the knowledge provider 410 is included.

The knowledge framework 400 stores base knowledge reusable in different medical fields with a predefined knowledge structure. The knowledge stored in the knowledge framework 400 is knowledge that has already been verified through knowledge defined by knowledge engineers and the like and has been verified for clinical utility.

The knowledge design unit 402 uses the base knowledge of the knowledge framework 400 to design knowledge-based knowledge authoring in the medical field, and outputs the design result to the knowledge transformation unit 404. The knowledge design unit 402 includes open-based software that is highly related to standards in the medical field as a knowledge authoring tool.

The knowledge converting unit 404 converts the knowledge designed by the knowledge designing unit 402 into knowledge that can be searched by the reference server 146, and converts the converted knowledge into the knowledge viewer 406, the virtual execution unit 408, and the like. Output to any one or more of the knowledge provider 410.

The knowledge viewer 406 displays the knowledge converted by the knowledge converter 404 so that the knowledge can be inquired.

When the virtual execution unit 408 receives the converted knowledge from the knowledge conversion unit 404, the virtual execution unit 408 executes a virtual knowledge search to check the accuracy and stability of the converted knowledge.

The knowledge provider 410 transmits the knowledge converted by the knowledge converter 404 to the knowledge repository 145. The knowledge provider 410 is an automated tool for mounting knowledge on a remote server.

The knowledge repository 145 receives and stores the knowledge authored by the knowledge authoring unit 144.

FIG. 5 illustrates the detailed components of the knowledge repository 145 shown in FIG. 1 and includes a knowledge storage 500, a service result storage 502, and an associated data storage 504.

The knowledge storage unit 500 receives and stores the knowledge authored by the knowledge authoring unit 144 and transmits the stored knowledge to the reference server 146 according to the withdrawal request.

The service result storage unit 502 stores the service result of the clinical decision support. The service result storage unit 502 stores the search results of the patient information of the hospital information system 100 previously brought by the service provision and knowledge corresponding to the clinical decision support, thereby storing the cache function. To perform.

The related data storage unit 504 stores criteria and metadata for supporting clinical decision support.

The reference server 146 searches for knowledge for clinical decision support corresponding to the patient information retrieved from the interface server 143 with reference to the knowledge repository 145.

FIG. 6 illustrates the detailed components of the reference server 146 shown in FIG. 1, and includes a knowledge engine unit 600 and a medical function storage unit 602.

The knowledge engine 600 searches for knowledge stored in the knowledge repository 145 in response to the retrieved patient information, and outputs the searched result to the application driver 140. Retrieval of clinical knowledge compares current patient conditions with medical judgments based on pre-defined standard knowledge and, if the knowledge and current judgments differ, provides recommendations to the medical staff. Processing knowledge requires patient information to compare against predefined criteria. To this end, the patient information retrieved from the interface server 143 is used to retrieve knowledge corresponding to the patient information from the knowledge repository 145. Meanwhile, the knowledge engine unit 600 may request the interface server 143 for additional information about the patient information. Then, the interface server 143 generates a query accessible to the hospital information system 100 to search for additional information, and transmits the query to the hospital information system 100. Upon receiving the query, the hospital information system 100 retrieves the requested additional information and transmits the requested additional information to the interface server 143. The interface server 143 transmits the received additional information to the knowledge engine unit 600. The knowledge engine unit 600 retrieves the knowledge corresponding to the patient information and the additional information from the knowledge repository 145 based on the additional information on the received patient information.

The medical function storage unit 602 stores a processing function of medical knowledge.

The application driver 141 transmits the knowledge retrieved from the reference server 146 to the hospital information system 100 through the service interface 120 as information for clinical decision support.

7 is a reference diagram for explaining the operation of the clinical decision support system (CDSS) according to the present invention.

First, when a user (for example, a doctor or a nurse) requests to execute a clinical decision support service, a call of the CDSS application is made through the service interface, and the CDSS application is started. Thereafter, when the CDSS application requests patient information necessary for knowledge processing, the interface server uses the mapping information stored in the interface repository to make a query accessible to the hospital information system and transmit the query to the hospital information system. The hospital information system retrieves the patient information according to the query execution from the electronic medical records (EMR) database, and transmits the patient information corresponding to the result of the query execution to the CDSS. Then, when the CDSS application requests the knowledge engine to process the knowledge related to the patient information, the reference server retrieves the knowledge stored in the knowledge repository. On the other hand, when additional information of the patient stored in the hospital information system is needed during the knowledge search, additional information about the patient is obtained through the interface server. Thereafter, when the reference server completes the knowledge search, the search server delivers the search results to the CDSS application. The CDSS application stores the search results in the knowledge repository and outputs them to the hospital information system through the service interface.

Hereinafter, the clinical decision support method according to the present invention will be described in detail with reference to the accompanying drawings.

8 is a flowchart of an embodiment for explaining a clinical decision support method according to the present invention.

First, the clinical decision support application is driven in response to the user's request for clinical decision support (operation 700). The clinical decision support application is a unit module that provides clinical decision support services. It provides standard medical guidance (CPG) services, primary clinical pathway (CP) services, and drug interaction services.

After operation 700, the patient information for clinical decision support is searched for by referring to the interface repository that stores the standard and the electronic medical record (EMR) schema for each hospital (operation 702).

FIG. 9 is a flowchart of an exemplary embodiment for describing operation 702 illustrated in FIG. 8.

Using the mapping information of the standards-based electronic medical record schema stored in the interface repository and the electronic medical record schema of each hospital, a query accessible to the hospital information system is generated to search for patient information (step 800). Standard electronic medical record schema refers to the data structure for electronic medical records based on standard knowledge. The mapping information is information defining the correlation of the data structure of the electronic medical record of each hospital with respect to the data structure of the standard electronic medical record. This mapping information is used to create a query to access the hospital information system.

After operation 800, the generated query is transmitted to the hospital information system through the service interface (operation 802).

After step 802, a retrieved result of patient information is received from the hospital information system (step 804). When the hospital information system receives the query from the CDSS, the patient information is retrieved from the electronic medical records database and transmitted to the service interface. The clinical decision support system receives patient information from the service interface.

After operation 702, the knowledge repository for storing the clinical knowledge support for clinical decision support is searched for, and the knowledge for clinical decision support corresponding to the retrieved patient information is searched (operation 704). In response to the retrieved patient information, the knowledge stored in the knowledge repository is searched. Searching for clinical knowledge compares the current patient's condition with staff's judgments based on pre-defined standard knowledge and, if the knowledge and current judgments are different, provides the staff with recommendations defined in the knowledge. On the other hand, if additional information about the patient information is requested, a query accessible to the hospital information system is generated and transmitted to the hospital information system. Upon receiving the query, the hospital information system retrieves the requested additional information and sends it to the service interface. When the clinical decision support system receives the additional information from the service interface, it retrieves the patient information and the knowledge corresponding to the additional information based on the additional information on the received patient information.

After step 04, the retrieved knowledge is output to the user's hospital information system (step 706). It also stores the service results for the retrieved knowledge in the knowledge repository.

Meanwhile, the method inventions of the present invention described above can be implemented as computer readable codes / instructions / programs. That is, according to the clinical decision support request of the user, driving the clinical decision support application; Retrieving patient information for clinical decision support by referring to an interface repository having a standard and an electronic medical record (EMR) schema for each hospital; Retrieving knowledge for clinical decision support corresponding to the retrieved patient information by referring to a knowledge repository that stores standards-based knowledge for clinical decision support; And a computer-readable recording medium having recorded thereon a program for executing the step of outputting the retrieved knowledge to the hospital information system of the user is another object of the present invention.

For example, it may be implemented in a general-purpose digital computer for operating the code / instructions / program using a computer-readable recording medium. The computer-readable recording medium may include a magnetic storage medium (eg, ROM, floppy disk, hard disk, magnetic tape, etc.), an optical reading medium (eg, CD-ROM, DVD, etc.) and a carrier wave (eg Storage media, such as through the Internet). In addition, embodiments of the present invention may be implemented as a medium (s) containing computer readable code, such that a plurality of computer systems connected through a network may be distributed and processed. Functional programs, codes and code segments for realizing the present invention can be easily inferred by programmers in the art to which the present invention belongs.

The present inventors clinical decision support system and method have been described with reference to the embodiments shown in the drawings for ease of understanding, but this is only illustrative, various modifications and equivalents from those skilled in the art It will be appreciated that other embodiments are possible. Therefore, the true technical protection scope of the present invention will be defined by the appended claims.

1 is a block diagram of one embodiment for explaining a clinical decision support system (CDSS) in accordance with the present invention.

FIG. 2 illustrates the detailed components of the interface repository shown in FIG. 1.

FIG. 3 shows detailed components of the interface server shown in FIG. 1.

FIG. 4 illustrates detailed components of the knowledge authoring unit illustrated in FIG. 1.

FIG. 5 illustrates the detailed components of the knowledge repository shown in FIG. 1.

FIG. 6 shows detailed components of the conference server shown in FIG. 1.

7 is a reference diagram for explaining the operation of the clinical decision support system (CDSS) according to the present invention.

8 is a flowchart of an embodiment for explaining a clinical decision support method according to the present invention.

FIG. 9 is a flowchart of an exemplary embodiment for describing operation 702 illustrated in FIG. 8.

Claims (12)

An application driver for driving a clinical decision support application according to a user's request for clinical decision support; An interface repository that stores a standard and an electronic medical records (EMR) schema for each hospital; An interface server that searches for patient information for clinical decision support by referring to the interface repository according to the driving of the application driver; Knowledge authoring section for performing standards-based knowledge authoring for clinical decision support; A knowledge repository for storing knowledge authored by the knowledge authoring unit; And A reference server that searches for knowledge for clinical decision support corresponding to the patient information retrieved from the interface server by referring to the knowledge repository, And the application driver outputs the knowledge retrieved from the reference server to the hospital information system of the user as information for clinical decision support. The method of claim 1, wherein the interface repository is A standard EMR schema storage unit for storing the standard electronic medical record schema; A mapping information storage unit for storing mapping information between the standard electronic medical record schema and the electronic medical record schema for each hospital; And In order to link with an external device, clinical decision support system comprising a location information storage unit for storing the location information of the external device. The method of claim 1, wherein the interface server A data interface editing unit configured to edit mapping information of the standard electronic medical record schema and the electronic medical record schema for each hospital; A mapping information conversion unit for converting the mapping information edited in the data interface letter unit into Extensible Markup Language (XML); A query generator for generating a query accessible to the hospital information system for retrieving the patient information by using the mapping information converted by the mapping information converter; And And a data interface adapter for transmitting the query generated by the query generator to the hospital information system and receiving a search result of the patient information from the hospital information system. The method of claim 1, wherein the interface server And receiving additional information on the patient information from the conference server, generate a query accessible to the hospital information system, and retrieve the additional information. The method of claim 1, wherein the knowledge authoring unit A knowledge framework for storing base knowledge reusable in different medical disciplines with predefined knowledge structures; A knowledge design unit for designing standards-based knowledge authoring in the medical field using the knowledge of the knowledge framework; A knowledge converting unit converting the knowledge designed by the knowledge designing unit into knowledge that can be searched by the reference server; A knowledge viewer which displays the knowledge converted by the knowledge conversion unit; A virtual execution unit that checks the accuracy and stability of the converted knowledge; And And a knowledge transmitter for transmitting the converted knowledge to the knowledge repository. The method of claim 1, wherein the knowledge repository is A knowledge storage unit for receiving and storing the knowledge authored by the knowledge authoring unit; A service result storage unit for storing a service result of clinical decision support; And A clinical decision support system comprising a related data storage for storing criteria and metadata for clinical decision support. The method of claim 1, wherein the reference server is A knowledge engine unit searching for knowledge stored in the knowledge repository in response to the retrieved patient information; And A clinical decision support system comprising a medical function storage unit for storing a treatment function of medical-specific knowledge. In response to a user's request for clinical decision support, launching a clinical decision support application; Retrieving patient information for clinical decision support by referring to an interface repository having a standard and an electronic medical record (EMR) schema for each hospital; Retrieving knowledge for clinical decision support corresponding to the retrieved patient information by referring to a knowledge repository that stores standards-based knowledge for clinical decision support; And And outputting the retrieved knowledge to the hospital information system of the user. The method of claim 8, wherein retrieving the patient information Generating a query accessible to the hospital information system for retrieval of the patient information by using mapping information of the standards-based electronic medical record schema and the respective electronic medical record schemas; Transmitting the generated query to the hospital information system; And And receiving the retrieved result of the patient information from the hospital information system. The method of claim 8, wherein the retrieving of the knowledge is And requesting additional information about the patient information, generating a query accessible to the hospital information system and retrieving the additional information. The method of claim 8, wherein the clinical decision support method is And storing the service result of the retrieved knowledge. In response to a user's request for clinical decision support, launching a clinical decision support application; Retrieving patient information for clinical decision support by referring to an interface repository having a standard and an electronic medical record (EMR) schema for each hospital; Retrieving knowledge for clinical decision support corresponding to the retrieved patient information with reference to a knowledge repository that stores standards-based knowledge for clinical decision support; And A computer-readable recording medium having recorded thereon a program for executing the step of outputting the retrieved knowledge to the hospital information system of the user.

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