. "2 A Vision for 21st Century Health Care and Wellness." Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. Washington, DC: The National Academies Press, 2009.
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Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions
individuals absorb or clear medications from their bodies, a blood sampleof the patient in question is analyzed with a mass spectrometer or othersimilar device, and the resulting spectrum identifies the actual level ofall drugs in the patient’s body. Combined with information from thesmart table, a profile of the patient’s compliance and pharmacokinetics for each drug is generated. The clinical significance of the smartmedications table and the mass spectrometer is that together they helpto reduce uncertainty by synthesizing different views into the patient’smedication history.
Cognitive support for health care professionals and patients to help integrate patient-specific data where possible and account for any uncertainties that remain.4
A primary care clinician needs to monitor a patient’s heart condition.Cardiac information is provided to the clinician not in the form of tablesof numbers or individual EKG plots, but rather as an overlay on a visualanimated structural model of the patient’s heart (not a generic heart)derived from various imaging modalities. The system displays the relevant functional information in summary form and provides an imageof the heart in operation driven by all of the data that have been collectedabout the patient over time. Different time scales are available for display, and the clinician can display an animated image of the patient’sheart in operation as the patient is resting or exerting himself (i.e., innear-real time), or track how the structure of the heart has changedover the last 2 years using time-lapse-like sequences. Functional histories are also available. Histories are instantly available in easy-to-readform, with different parameter histories presented on similar-lookingcharts normalized to z-scores and timescales, showing upper and lower“normal” and physiologic bounds.5The clinician also has the abilityto drill down to any supporting piece of information that underlies thedisplay. The clinical significance of an animated structural model isthat it drastically reduces the cognitive effort needed for the clinician tovisualize the heart functioning in this particular patient, freeing her touse those cognitive resources for other related tasks. The model also helpsthe patient to understand the medical situation at hand and assists bothclinician and patient in determining an appropriate course of action.
In this report, “cognitive support” refers to IT-based tools and systems that provide users (clinicians and patients) with the information, abstractions, and models needed to achieve the IOM’s vision of health care quality.