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Erschienen in: World Journal of Surgery 4/2010

01.04.2010

Multimedia Abstract Generation of Intensive Care Data: The Automation of Clinical Processes Through AI Methodologies

verfasst von: Desmond Jordan, Sydney E. Rose

Erschienen in: World Journal of Surgery | Ausgabe 4/2010

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Abstract

Medical errors from communication failures are enormous during the perioperative period of cardiac surgical patients. As caregivers change shifts or surgical patients change location within the hospital, key information is lost or misconstrued. After a baseline cognitive study of information need and caregiver workflow, we implemented an advanced clinical decision support tool of intelligent agents, medical logic modules, and text generators called the “Inference Engine” to summarize individual patient’s raw medical data elements into procedural milestones, illness severity, and care therapies. The system generates two displays: 1) the continuum of care, multimedia abstract generation of intensive care data (MAGIC)—an expert system that would automatically generate a physician briefing of a cardiac patient’s operative course in a multimodal format; and 2) the isolated point in time, “Inference Engine”—a system that provides a real-time, high-level, summarized depiction of a patient’s clinical status. In our studies, system accuracy and efficacy was judged against clinician performance in the workplace. To test the automated physician briefing, “MAGIC,” the patient’s intraoperative course, was reviewed in the intensive care unit before patient arrival. It was then judged against the actual physician briefing and that given in a cohort of patients where the system was not used. To test the real-time representation of the patient’s clinical status, system inferences were judged against clinician decisions. Changes in workflow and situational awareness were assessed by questionnaires and process evaluation. MAGIC provides 200% more information, twice the accuracy, and enhances situational awareness. This study demonstrates that the automation of clinical processes through AI methodologies yields positive results.
Literatur
1.
Zurück zum Zitat Haig KM, Sutton S, Whittington J (2006) SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf 32(3):167–175PubMed Haig KM, Sutton S, Whittington J (2006) SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf 32(3):167–175PubMed
2.
Zurück zum Zitat Homsted L (2000) Institute of Medicine report: to err is human: building a safer health care system. Fl Nurse 48(1):6PubMed Homsted L (2000) Institute of Medicine report: to err is human: building a safer health care system. Fl Nurse 48(1):6PubMed
3.
Zurück zum Zitat Leonard M, Graham S, Bonacum D (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 13(Suppl 1):i85–i90CrossRefPubMed Leonard M, Graham S, Bonacum D (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 13(Suppl 1):i85–i90CrossRefPubMed
4.
Zurück zum Zitat McKeown K et al (2000) A study of communication in the cardiac surgery intensive care unit and its implications for automated briefing. Proc AMIA Symp, pp 570–574 McKeown K et al (2000) A study of communication in the cardiac surgery intensive care unit and its implications for automated briefing. Proc AMIA Symp, pp 570–574
5.
Zurück zum Zitat Hughes RG, Clancy CM (2007) Improving the complex nature of care transitions. J Nurs Care Qual 22(4):289–292PubMed Hughes RG, Clancy CM (2007) Improving the complex nature of care transitions. J Nurs Care Qual 22(4):289–292PubMed
6.
Zurück zum Zitat Jordan DA, McKeown K, Concepcion K, Feiner S, Hatzivassiloglou V (2003) Generation and evaluation of intraoperative inferences for automated health care briefings on patient status after bypass surgery. Yearbook of medical informatics: quality of health care, the role of informatics, IMIA, pp 406–419 Jordan DA, McKeown K, Concepcion K, Feiner S, Hatzivassiloglou V (2003) Generation and evaluation of intraoperative inferences for automated health care briefings on patient status after bypass surgery. Yearbook of medical informatics: quality of health care, the role of informatics, IMIA, pp 406–419
7.
Zurück zum Zitat Jordan DA et al (2001) Generation and evaluation of intraoperative inferences for automated health care briefings on patient status after bypass surgery. J Am Med Inf Assoc 8:267–280PubMed Jordan DA et al (2001) Generation and evaluation of intraoperative inferences for automated health care briefings on patient status after bypass surgery. J Am Med Inf Assoc 8:267–280PubMed
8.
Zurück zum Zitat Knaus WA, Wagner DP, Draper EA (1991) The apache III prognostic system: risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100:1619–1636CrossRefPubMed Knaus WA, Wagner DP, Draper EA (1991) The apache III prognostic system: risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100:1619–1636CrossRefPubMed
9.
Zurück zum Zitat Jordan D, Miller C, Kubos K, Rogers M (1987) Evaluation of sepsis in a critically ill surgical population. Crit Care Med 15:897–904CrossRefPubMed Jordan D, Miller C, Kubos K, Rogers M (1987) Evaluation of sepsis in a critically ill surgical population. Crit Care Med 15:897–904CrossRefPubMed
10.
Zurück zum Zitat Dalal M, Feiner S, McKeown K et al (1996) Negotiation for automated generation of temporal multimedia presentations. Proceedings of the 4th ACM international conference on multimedia, November 18–22, 1996, Boston, Massachusetts, pp 55–64 Dalal M, Feiner S, McKeown K et al (1996) Negotiation for automated generation of temporal multimedia presentations. Proceedings of the 4th ACM international conference on multimedia, November 18–22, 1996, Boston, Massachusetts, pp 55–64
11.
Zurück zum Zitat Jordan DA, Whalen G, Bell B, McKeown K, Feiner S (2004) An evaluation of automatically generated briefings of patient status. Presentation from the proceedings of MedInfo, JAMIA, SF Jordan DA, Whalen G, Bell B, McKeown K, Feiner S (2004) An evaluation of automatically generated briefings of patient status. Presentation from the proceedings of MedInfo, JAMIA, SF
12.
Zurück zum Zitat McKeown K, Pan S, Shaw J, Jordan D, Allen B (1997) Language generation for multimedia healthcare briefings. Proc Appl NLP, pp 277–282 McKeown K, Pan S, Shaw J, Jordan D, Allen B (1997) Language generation for multimedia healthcare briefings. Proc Appl NLP, pp 277–282
13.
Zurück zum Zitat Zhou M, Feiner S (1998) Automated production of visualizations: from heterogeneous information to coherent visual discourse. J Intell Info Sys 11(3):205–234CrossRef Zhou M, Feiner S (1998) Automated production of visualizations: from heterogeneous information to coherent visual discourse. J Intell Info Sys 11(3):205–234CrossRef
14.
Zurück zum Zitat McKeown K, Pan S (2000) Prosody modeling in concept-to-speech generation: methodological issues. Phil Trans R Soc Lond 358(1769):1419–1431CrossRef McKeown K, Pan S (2000) Prosody modeling in concept-to-speech generation: methodological issues. Phil Trans R Soc Lond 358(1769):1419–1431CrossRef
15.
Zurück zum Zitat Zimmerman JE, Knaus WA, Sun X, Wagner DP (1996) Severity stratification and outcome prediction for multisystem organ failure and dysfunction. World J Surg 20(4):401–405CrossRefPubMed Zimmerman JE, Knaus WA, Sun X, Wagner DP (1996) Severity stratification and outcome prediction for multisystem organ failure and dysfunction. World J Surg 20(4):401–405CrossRefPubMed
16.
Zurück zum Zitat Cullen DJ, Keene R, Waternaux C et al (1984) Objective, quantitative measurement of severity of illness in critically ill patients. Crit Care Med 5:137 Cullen DJ, Keene R, Waternaux C et al (1984) Objective, quantitative measurement of severity of illness in critically ill patients. Crit Care Med 5:137
17.
Zurück zum Zitat Miller P (1981) Anesthesia. Churchill livingstone, New York Miller P (1981) Anesthesia. Churchill livingstone, New York
18.
Zurück zum Zitat Block F (1991) Normal fluctuation of physiologic cardiovascular variables during anesthesia and the phenomenon of “smoothing”. J Clin Monit 7:141–145CrossRefPubMed Block F (1991) Normal fluctuation of physiologic cardiovascular variables during anesthesia and the phenomenon of “smoothing”. J Clin Monit 7:141–145CrossRefPubMed
Metadaten
Titel
Multimedia Abstract Generation of Intensive Care Data: The Automation of Clinical Processes Through AI Methodologies
verfasst von
Desmond Jordan
Sydney E. Rose
Publikationsdatum
01.04.2010
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 4/2010
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0319-5

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