Coupling computer-interpretable guidelines with a drug-database through a web-based system – The PRESGUID project

BACKGROUND: Clinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context. OBJECTIVE: The PRESGUID project (PREScription and GUIDelines) aims to improve the assistance provided by guidelines. The project proposes an online service enabling physicians to consult computerized CPGs linked to drug databases for easier integration into the healthcare process. METHODS: Computable CPGs are structured as decision trees and coded in XML format. Recommendations related to drug classes are tagged with ATC codes. We use a mapping module to enhance computerized guidelines coupling with a drug database, which contains detailed information about each usable specific medication. In this way, therapeutic recommendations are backed up with current and up-to-date information from the database. RESULTS: Two authoritative CPGs, originally diffused as static textual documents, have been implemented to validate the computerization process and to illustrate the usefulness of the resulting automated CPGs and their coupling with a drug database. We discuss the advantages of this approach for practitioners and the implications for both guideline developers and drug database providers. Other CPGs will be implemented and evaluated in real conditions by clinicians working in different health institutions

Medical insecurity: when one size does not fit all

Security is most commonly seen as a business concept. This is one, reason for the poor uptake and implementation of standard security processes in non-business environments such as general medical practice. It is clear that protection of sensitive patient information is imperative yet the overarching conceptual business processes required to ensure this protection are not well suited to this context. The issue of sensitivity of information. together with the expectation that security can be effectively implemented by non-security trained professionals creates an insecure environment. The general security processes used by business, including those for risk assessment, are difficult to operationally put into practice in the medical environment and this one-sizefits- all approach is shown to be ineffective. Therefore more explicit models are required which provide contextually relevant guidance and can be implemented within the capability of those using them

Medical insecurity: when one size does not fit all

Security is most commonly seen as a business concept. This is one reason for the poor uptake and implementation of standard security processes in non-business environments such as general medical practice. It is clear that protection of sensitive patient information is imperative yet the overarching conceptual business processes required to ensure this protection are not well suited to this context. The issue of sensitivity of information, together with the expectation that security can be effectively implemented by non-security trained professionals creates an insecure environment. The general security processes used by business, including those for risk assessment, are difficult to operationally put into practice in the medical environment and this one-sizefits- all approach is shown to be ineffective. Therefore more explicit models are required which provide contextually relevant guidance and can be implemented within the capability of those using them