An intelligent clinical information management support system for the critical care medical environment
Significant advances have been achieved in the fields of medical informatics and artificial intelligence in medicine in the past three decades and, having demonstrated an ability to support clinical decisions, knowledge-based systems are becoming increasingly ubiquitous in various clinical settings. Nonetheless, few systems have so far been successful in entering routine use. On the one hand, primarily due to methodological difficulties and with very few exceptions, developers have failed to show that pertinent systems are effective in improving patient care. On the other hand, support systems have not been sufficiently well integrated into the routine information processing activity of the clinical users. As a consequence, their clinical utility is disputed and constructive assessmenist further hindered. This thesis describes the development of an intelligent clinical information management support system designed to overcome these obstacles through the adoption of an integrated approach, geared toward the solution of the problems encountered in the acquisition, organisation, review and interpretation of the clinical decision supporting information utilised in the process of monitoring intensive care unit patients with acid-base balance disorders. The system was developed to support this activity incrementally, using the methods of object-oriented analysis, design and implementation, with the active participation of a clinical advisor who assessed the functional and ergonomic compatibility of the system with the supported activity and the integration of a previously validated prototype knowledge-based data interpretation system, which could not evaluated in the clinical setting for the reasons described above.