technical aspects of the infobutton manager james j. cimino columbia university

Technical Aspects of the Infobutton Manager

James J. Cimino

Columbia University

Overview

• History (Medline Button and Infobuttons• Architectural Overview of the Infobutton Manager• Demo (WebCIS and Eclipsys)• How Infobutton Manager links work• Terminology Issues• Integrating with clinical systems• How can I play?

Infobutton Manager Architecture

Context

ContextMatching

QuestionSelection

Instantiation

Links

Infobutton Manager

Context Table

Question Table

Resolving Clinician Information Needs

InformationNeed TriggeredBy Clinical Data

1

ExtractContext Data

2

ContextMatching

3

QuestionSelection

4

Presentation ofQuery Results

7

PresentationOf Questions

5

Query aResource

6

Infobutton Manager Infobutton

Demonstrations

• WebCIS• Eclipsys XA

How Infobutton Manager Links Work

• Simple link• Concept-based link• Simple search• Concept-based search• Intelligent agent• Calculator

• Match concept of interest to class(es)

• Identify context based on class(es)

• Retrieve question(s) for context

• Sort by “priority”

• Return HTML page of links (URLs)


• Simple link• Concept-based

link• Simple search• Concept-based

search• Intelligent agent• Calculator

• Question has “hardcoded” URL

e.g.: “www.columbia.edu/potassium.pdf”

http://infonet.nyp.org/Pharmacy/Pharmacy-M/AdultPotassium_030503_.pdf





• Translate concept of interest to controlled term

• Find controlled term in data dictionary

• Obtain term attribute for constructing URL from data dictionary

• Construct URL, e.g.: www.columbia.edu/lab/<>.html

+ cl001900 . www.columbia.edu/lab/cl001900.html

http://cpmclabinfo.cpmc.columbia.edu/chapter/mono/cl001900.htm#Container





Insert concept of interest into CGI function call as a parameter

e.g.: www.Uptodate.com/search.cgi?term=<>+ POTASSIUM .www.Uptodate.com/search.cgi?term=POTASSIUM

http://…./vocab.asp&search=POTASSIUM&submit=Go&app=utdol





• Translate concept of interest to controlled term

• Obtain term translation from data dictionary

• Insert translated term into CGI function call as a parameter

e.g.: pubmed.gov/search.cgi?term=<>[MeSH+Terms]+

Potassium .

pubmed.gov/search.cgi?term=Potassium[MeSH+ Terms]

http://…/entrez/query.fcgi?…POTASSIUM[MeSH+Terms]+toxicity[MeSH+…





• Resource is not a simple document or search CGI

• Log-on, navigation or other interaction required

• Multiple context parameters used

• Agent:- parses context parameters- interacts with resource- parses results- presents summary- may modify links

…#PDRADR01





• No resource available

• Interaction too complex

• Create self-contained agent:- parses context parameters- constructs Web page- presents results - may have Infobuttons of its own

The Coumadin Story

• Chair of Medicine wants link to Coumadin protocol

• First, I have to find the guidelines

The Coumadin Story

• Chair of Medicine wants link to Coumadin protocol

• First, I have to find the guidelines

• Then I have to add the question to the IM table

The Coumadin Story

• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table

• Finally, I link the question to the context…

The Coumadin Story

• Chair of Medicine wants link to Coumadin protocol• First, I have to find the guidelines• Then I have to add the question to the IM table• Finally, I link the question to the context…

• … and I’m done - about 15 minutes.

How can I play?

• Can your system evoke a Web browser?

• Can you customize the URL?

“GET” Method:

<a href=“flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi? Info_institute=CPMC&info_med=1560&info_context=LabDetail”> <img info.gif\"></a>

- OR -“POST” Method:<form method="POST" TARGET="INFO" NAME="INFO" action="flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="info_med" value="1560"><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name=“DOB" value="1951-05-26"><input type="HIDDEN" name=“info_age" value=“52"><input type="HIDDEN" name=“info_sex" value="F"><input type="HIDDEN" name=“info_usertype" value=“MD"><input type="HIDDEN" name=“info_mrn" value="3131313"><input type="HIDDEN" name=“info_user" value="ciminoj"><input type="HIDDEN" name="info_other" value="1560|6.8|10.0-20.0|mg/l|1559|29.7|20.0-40.0|mg/l|"></form>

Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “14877-5” (the LOINC Code) and “PHENYTOIN”.

How can I play?

• Can your system evoke a Web browser?

• Can you customize the URL?• Decide what information needs you have

• Decide how you want to address the needs

“GET” Method:

<a href=“flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi? Info_institute=CPMC&info_med=1560&info_context=LabDetail”> <img info.gif\"></a>

- OR -“POST” Method:<form method="POST" TARGET="INFO" NAME="INFO" action="flux.cpmc.columbia.edu/webcisdev13/wc_infomanage.cgi"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="info_med" value="1560"><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name=“DOB" value="1951-05-26"><input type="HIDDEN" name=“info_age" value=“52"><input type="HIDDEN" name=“info_sex" value="F"><input type="HIDDEN" name=“info_usertype" value=“MD"><input type="HIDDEN" name=“info_mrn" value="3131313"><input type="HIDDEN" name=“info_user" value="ciminoj"><input type="HIDDEN" name="info_other" value="1560|6.8|10.0-20.0|mg/l|1559|29.7|20.0-40.0|mg/l|"></form>

Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “14877-5” (the LOINC Code) and “PHENYTOIN”.

Infobutton Manager Parameters

How can I play?

• Can your system evoke a Web browser?• Can you customize the URL?• Decide what information needs you have• Decide how you want to address the needs

• Address the terminology issue

Automated Retrieval with Clinical Data

UnderstandInformation

Needs

1

Get InformationFrom EMR

2

AutomatedTranslation

5

ResourceTerminology

4

Presentation

7ResourceSelection

3

Querying

6MRSA

How can I play?

• Can your system evoke a Web browser?• Can you customize the URL?• Decide what information needs you have• Decide how you want to address the needs• Address the terminology issue

• Coordinate with me

<a href="Javascript:get_info('35702')"><img src="info.gif"></a>

function get_info(mc){ var infowin = window.open("","INFO"); infowin.focus(); document.INFO.info_med.value=mc; document.INFO.submit(); }

<form method="POST" name=“INFO” action="wc_infomanage.cgi"><input type="HIDDEN" name="info_med" value=""><input type="HIDDEN" name="info_context" value="LabDetail"><input type="HIDDEN" name="info_institute" value="CPMC"><input type="HIDDEN" name="DOB" value="1951-05-26"><input type="HIDDEN" name="SEX" value="F"><input type="HIDDEN" name="USER" value="ciminoj"></form>

Acknowledgments

• National Library of Medicine research grant

• National Library of Medicine training grant

• National Institute of Nursing Research

[email protected]

www.dmi.columbia.edu/homepages/ciminoj/Infobuttons.html

technical aspects of the infobutton manager james j. cimino columbia university

Documents

utdol slide

contai slide

match concept

infobutton manager james

infobutton manager demo

controlled term

translated term

term attribute