Computer-Mediated Guideline Implementation Projects
Overview
AsthMonitor
Information Management Services Model
PalmAsthma
Object-Oriented Framework
Publications
A major goal of the AsthMonitor project is to find ways to integrate clinical decision support&emdash;based on high-quality guideline knowledge&emdash;with clinical workflow support. Clinical workflow refers to the complex interacting tasks performed by clinicians as they go about their daily work and to the corresponding information flows that are generated. Workflow support is a critical factor in the acceptance and use of computer system. Automation is unlikely to be successful unless it produces a net benefit for users to offset the costs of its use. Several activities in the outpatient care of asthmatic children generate information flows that are amenable to automation, e.g., documentation of findings and interventions, calculation of medication dosages, and printing of prescriptions and patient education materials.
AsthMonitor was built as a standalone application to run on the Newton MessagePad
&emdash;a handheld computer that uses a pen-like stylus for handwritten data entry on
a touch-sensitive screen.
The pen-based data entry mode seems intuitive and is intended to overcome the reluctance
of many clinicians to use keyboard-based computers. The MessagePad is about the size of a
videotape cassette and it weighs only 1.0 lb. Custom-developed software (written in
the NewtonScript language) was installed that implemented a guideline on office management
of asthma exacerbations in children (developed by the American Academy of Pediatrics).
The AMOS Trial (Asthma Management in the Office Setting) evaluated AsthMonitor's effectiveness and usability.