Health Sciences 4700 Spring 2009 Chapter Decision Support Systems What are decision support systems (DSSs)?  Computer systems that assist decision makers   Combine “machine” or “artificial intelligence” with information about the domain of interest Intended to make knowledge more readily available at the point of care Simple DSSs     CPOE system with drug interaction alerts EHR with alerts for missing or unknown information Database with structured queries to find relevant information Differential diagnosis systems (e.g., FirstConsult) Components of an advanced DSS  Data management system   Model management system   Computations that represent domain models Knowledge-based management system   Database and query system “Captured” knowledge and reasoning User interface  Input/output, documentation Types of advanced DSSs        Expert systems Neural networks Intelligent agents Knowledge management systems Information systems Group support systems Enterprise planning and management systems Characteristics of DSS      Used in un-/semi-structured decision contexts Support decision makers, not replace them Rely on data and models Generally developed using an evolutionary, iterative process Focus should be on complete system (including people and procedures, not just computers) Application domains  Administrative decision support        Access and organization of data Analysis of data Analysis of multiple data sources Accounting and modeling of data Forecasting from data Optimization and comparison of alternatives Suggestions of action based on comparisons Application domains  Clinical decision support     Access to information (EHR) Analysis of data (single or multiple sources) Diagnosis Recommendations for treatments/procedures Why DSSs?  Information overload   Experience and expertise is learned over many years   Current research and evidence far outstrips any individual’s capacity to absorb it Senior clinicians are often not involved from direct care Knowledge and reasoning can help prevent medical errors Applications of DSS  Reminders and alerts    Prescribing systems Therapy planning and critiquing   Provide complete information at point of care Identify inconsistencies, errors, omissions Image recognition  Identify potential abnormalities, changes Rule-based systems (example) IF dipstick = pink THEN test