Abstract
Patients are becoming more and more involved in clinical decision-making process. Several factors support this process. Advances in omics allows individualization of diagnosis and treatment. Patient awareness and easy availability of data on the Internet allows patients to become informed decision makers when it comes even to disease management. Mass media emphasize the issue of medical errors, making patients demanding for quality in medical care. In some healthcare settings, patents face a problem of interpreting medical data and making decisions on treatment tactics without having a doctor, who could potentially support them. Delegating this task to a Patient Decision Aide system can add automatically generated recommendations to result reports without adding significant workload on the doctors, increase patients’ motivation and support their decisions. We have implemented a patient decision aid system based on the productions rules, which: Collects data from available sources; Automatically analyses and interprets laboratory test results; Recommends running additional tests for a more precise diagnostic; Delivers automatically generated reports to doctors and patients in a natural language. To achieve semantic interoperability with other systems we have implemented a FHIR engine. The knowledge base has been organized as a graph structure. The application is structured as a set of lightly coupled services, which implement the logic of the decision support system. In total, we have modelled 365 nodes of test components, 5084 nodes of inference rules, 49932 connections and 3072 blocks of text for medical certificates. The findings of the research provide a deep understanding of how the semantically interoperable clinical decision support systems are implemented. Advances in notification the patients with the elements of patient decision aid is important for clinical data management, and for patients’ empowerment and protection. We suppose that the system empowering patients in such way can play a meaningful role in helping patients to make informed decisions during the process of diagnostics and treatment.
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Funding
The research is funded from Russian Science Foundation (RSF), The research was at Tomsk Polytechnic University within the framework of Tomsk Polytechnic University Competitiveness Enhancement Program grant.
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Ilia Semenov declares that he has no conflict of interest; Georgy Kopanitsa declares that he has no conflict of interest; Dmitry Denisov declares that he has no conflict of interest; Yakovenko Alexandr declares that he has no conflict of interest; Osenev Roman declares that he has no conflict of interest; Andreychuk Yury declares that he has no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Semenov, I., Kopanitsa, G., Denisov, D. et al. Patients Decision Aid System Based on FHIR Profiles. J Med Syst 42, 166 (2018). https://doi.org/10.1007/s10916-018-1016-4
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DOI: https://doi.org/10.1007/s10916-018-1016-4