The document describes a proposed clinical decision support system to be embedded within the existing electronic medical record system CHITS. The system would help physicians diagnose and treat patients. It allows recording patient information, analyzing cases by entering symptoms, displaying likely diseases, providing evidence about diseases, and recommending treatments including tests, medications, and scheduling follow ups. Warnings would alert about dosage errors. The system aims to make patient visits and diagnoses more efficient.

1. http://info.isabelhealthcare.com
CLINICAL DECISION
SUPPORT SYSTEM
Mary Grace A. Villareal, RN

2. Assignment:
CHITS is an electronic medical record currently
being used by many regional health units
nationwide. Think of a clinical scenario and
suggest a clinical decision support system
embedded within CHITS to address this.

3. Clinical Scenario
䡦 Patient X, 4 y/o male experiences reduced appetite,
sore throat, chills and low grade fever for 3 days.
Recorded temperature ranging from 37.8 peaking
to 38. Rashes appeared in hands, feet and mouth of
the child, followed by blisters on the same areas.
Patient Y, 2 y/o female, sibling of patient X
experiences body malaise and sore throat since
yesterday.

4. Case Analysis
䡦 Case Findings - Findings that match the search will appear
in the Findings Window, Common Diseases are shown on
another section that are associated with some or all of the
case findings. This area is refreshed dynamically overtime
a new case finding is entered.
䡦 Refine Disease List - Contains other related clinical findings
that can narrow down the search to possible diagnosis. A
tick box can be shown to tell the system if a findings is
present (Y), absent (N) or unknown (U).
䡦 Disease Selection - When a user clicks on a disease, it will
bring up evidences for the disease selcted. It will update
the current case findings window.

5. Clinical Decision Support System
▪ Recording of patient information - Patient visits are more efficient having
reduced minutes of finding paper records to just seconds proving faster
patient record retrieval system. It also minimizes waiting time for services
spent by each patient and relative. Physician suspects a case of Hand, Foot
and Mouth Disease (HFMD).
▪ Case Analysis - Provide a patient’s age and gender together with a rough
estimate of the duration of the symptom or disease condition. Clinical
manifestations are entered by typing the first few letters, the system will
display the terms that contain the characters typed. Once you see the choice,
you can click and select it. To indicate the absence of findings click the (-)
sign prior to selecting the finding.

6. Clinical Decision Support System
Evidence of Disease - interface where Disease
Information, Disease Differential, External Sites Link,
Google Search.
http://www.bilbomatica-idi.es

7. Evidence of Disease
䡦 Clinical Manifestation (that Support Disease selection)
- will list clinical manifestations congruent with the
Disease selected. You will be prompted to add
finding to the Case Investigated.
䡦 Disease Information - gives the definition, list the
ICD10 codes, other names and etiology of the
disease, provides the symptoms in order of the
frequency with which they occur. It also proved links
to external references.
䡦 Disease Differential - shows the differential diagnosis
for the selected disease, it provides a list of diseases
associated with the selection.

8. Clinical Decision Support System
Treatment - Shows the laboratory test, diagnostic test
(and results), medication course available for the
disease.
A warning message for dose and
frequency errors that gives the
reason for the warning (Note that
the figure shows a translated
mockup)
Image Source: http://www.jmir.org

9. Treatment
䡦 Laboratory Test - Abnormal Lab Findings
(Increased and Decreased),
Microbiology and Serology Findings.
䡦 Diagnostic Test - Imaging and scans.
䡦 Drugs - Shows medication
contraindication/s, medication dosage
and routes.

10. Clinical Decision Support System
Consultation Scheduling - mark scheduled consultation
for the patient, referral, and follow up.
Image Source: http://www.cdssai.somee.com