1. Integration of Information Resources at the Point of Need James J. Cimino, M.D. Departments of Medicine and Medical Informatics Columbia University

2. Information at the Point of Need Physicians have information needs Information needs go unmet Computer-based data contributes to the problem

3. One-Stop Information Shopping? World Wide Web (The Hyperdocument) Information Resources Biblio- graphic Database Textbook Expert System Community Practitioner

4. One-Touch Information Shopping Information Resources World Wide Web (The Facilitator) Biblio- graphic Database Textbook Expert System Community Practitioner

5. Infobutton: Automating the Process Questions can be anticipated Match information source to question Automate the retrieval Query can use patient information

6. Information for Decision-Making

8. ? MRSA Information for Decision-Making

9. Intelligent Decision Support

11. Query MRSA Intelligent Decision Support ? Result !

12. MRSA Intelligent Decision Support

13. Obstacles MRSA

14. Obstacles Understand Information Needs 1 MRSA

15. Obstacles Get Information From EMR Understand Information Needs 1 2 MRSA

16. Obstacles Get Information From EMR Resource Selection Understand Information Needs 1 2 3 MRSA

17. Obstacles Get Information From EMR Resource Selection Resource Terminology Understand Information Needs 1 24 3 MRSA

18. Obstacles Get Information From EMR Resource Selection Resource Terminology Understand Information Needs Automated Translation 1 254 3 MRSA

19. Obstacles Get Information From EMR Resource Selection Resource Terminology Querying Understand Information Needs Automated Translation 1 254 6 3 MRSA

20. Obstacles Get Information From EMR Resource Selection Resource Terminology Querying Presentation Understand Information Needs Automated Translation 1 254 6 3 7 MRSA

48. Integration of Resources Drug orders: to Micromedex, Medline Culture results: to Medline Sensitivities: to Micromedex, Medline X-rays to: to X-rays, Medline, U. of Utah Lab results: to DXplain EMR: to cholesterol guideline, mammography guideline

49. Summary On-line information sources exist Automated retrievals are possible Linking the patient-specific record to patient-relevant medical knowledge Further study needed: –how to anticipate questions –how to find the right resources –how to compose search strategies –how to present results