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 ContextContext Context Matching Question Selection Instantiation LinksLinks Infobutton Manager Context Table Question Table

Resolving Clinician Information Needs Information Need Triggered By Clinical Data 1 Extract Context Data 2 Context Matching 3 Question Selection 4 Presentation of Query Results 7 Presentation Of Questions 5 Query a Resource 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)

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator Question has “hardcoded” URL e.g.: “

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator 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.: + cl

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator Insert concept of interest into CGI function call as a parameter e.g.: + POTASSIUM.

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator 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]

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator 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

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

…#PDRADR01

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator No resource available Interaction too complex Create self-contained agent: - parses context parameters - constructs Web page - presents results - may have Infobuttons of its own

How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator

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: - OR - “POST” Method: Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “ ” (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: - OR - “POST” Method: Note that “1560” is the MED Code for Serum Phenytoin Test. Other acceptable values for info_med include “ ” (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 Understand Information Needs 1 Get Information From EMR 2 Automated Translation 5 Resource Terminology 4 Presentation 7 Resource Selection 3 Querying 6 MRSA

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

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">

Acknowledgments National Library of Medicine research grant National Library of Medicine training grant National Institute of Nursing Research