CLINICAL DECISION SUPPORT - A CLINICIANS VIEW - Christoph Mitsch, MD Department of Ophthalmology and Optometry Head: Univ.-Prof. Dr. Ursula Schmidt-Erfurth Medical University of Vienna Workshop: Clinical decision support in practice HL7 standards, interoperability, and selected applications ehealth Summit 2016 24.5.2016 Schönbrunn, Vienna, Austria
Contents Why clinical decision support? Example: Efforts and Strategy to establish Precision Medicine in Ophthalmology
Why Clinical Decision Support?
Why Clinical Decision Support? male female
Why Clinical Decision Support?
Outpatients (Ophthalmology, Vienna) Why Clinical Decision Support? 2500 2000 1500 1000 500 0 199419951996199920002001200220032004200520062007200820092010201120122013
Why Clinical Decision Support? number of publications 1400000 1200000 1000000 800000 600000 400000 200000 0 1950 1952 1954 1956 1958 1960 1962 1964 1966 1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 Automated yearly statistics of PubMed results for any query, 2004. Web resource at URL: http://dan.corlan.net/medline-trend.html
Why Clinical Decision Support? public + private sectors (USD/capita)
Healthcare Challenges Quantitative Age-related Lifestyle-related Medicine itself-related Qualitative Medicine is on the doorstep to Precision Medicine: Better, but largely more expensive and complicated diagnosis Better, but largely more expensive and costly (time and money) treatment
ehealth as a solution Guideline-based management and treatment Available Knowledge Management Systems Assures quality Optimizes resources Population-based studies (EHR)
CDS and precision medicine - in Ophthalmology -
OCT FA Imaging AF CF OCT-A
Moving towards Precision Medicine
Example: Macular Edema Intraretinal fluid Subretinal fluid
Morphological Patterns Intraretinal cystoid fluid over time in patients with retinal vein occlusion
Stratified Medicine
An integrated view on clinical Ophthalmology OCT FA Imaging AF CF OCT-A
An integrated view on clinical Ophthalmology ELGA OCT ehealth Electronic Health Records (EHR) ViDiNet AKIM Imaging FA AF Multimodal imaging Healthcare Delivery Process Mgmt. AKIM: Zeiss Forum Morphology + Morphometry CF OCT-A Method evaluation Integrated Health Care HL7 CDA Guide Ophthalmology Structured Data Models Hypothesis Generation Phenotyping Phase-3 Studies: Safety/Efficiency Translational research Interoperability OphthalNet Advanced education Data models + processing Implementation Projects A.I. + Clinical Decision Support Stratified medicine Personalized medicine Precision medicine Individualized therapy Ressource Optimization Health Improvement
Conclusion Clinical Decision Support Systems and Knowledge Management Systems will soon be essential to enable physicians to provide up-to-date care
Conclusion Translational research result and implementation cycles are getting shorter: Standards need to be applied and test platforms must be implemented to improve transition.
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