1. Technical Aspects of the Infobutton Manager James J. Cimino Columbia University

2. 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?

12. Infobutton Manager Architecture ContextContext Context Matching Question Selection Instantiation LinksLinks Infobutton Manager Context Table Question Table

13. 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

14. Demonstrations WebCIS Eclipsys XA

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

19. 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)

20. How Infobutton Manager Links Work Simple link Concept-based link Simple search Concept-based search Intelligent agent Calculator Question has “hardcoded” URL e.g.: “www.columbia.edu/potassium.pdf”

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

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

23. 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.: www.columbia.edu/lab/<>.html + cl001900. www.columbia.edu/lab/cl001900.html

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

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

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

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

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

29. 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]

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

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

32. 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

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

34. …#PDRADR01

35. 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

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

38. The Coumadin Story Chair of Medicine wants link to Coumadin protocol First, I have to find the guidelines

40. 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

42. 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…

44. 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.

48. How can I play? Can your system evoke a Web browser? Can you customize the URL?

49. “GET” Method: - OR - “POST” Method: 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”.

50. 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

51. “GET” Method: - OR - “POST” Method: 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

52. 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

53. 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

54. 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

55. 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">

57. Acknowledgments National Library of Medicine research grant National Library of Medicine training grant National Institute of Nursing Research jjc7@columbia.edu www.dmi.columbia.edu/homepages/ciminoj/Infobuttons.html