Gretchen P. Purcell

What makes a good clinical decision support system

We have some answers, but implementing good decision support is still hard C linical decision support is the provision of “clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care.”1 Medical institutions are increasingly adopting tools that offer decision support to improve patient outcomes and reduce errors. Healthcare providers and administrators with little or no training in computer science may be asked to evaluate, select, or contribute to the development of decision support systems for their practices. Is there an easy way to determine which clinical decision support systems are good? In this issue Kawamoto and colleagues provide some evidence based guidance in a systematic analysis of the ability of decision support systems to improve practice in …

Development and evaluation of a context-based document representation for searching the medical literature

Conventional full-text systems represent documents as sets of

Robert Wood Johnson Foundation Office of promoting excellence in end-of-life care: Executive summary of the report from the field

I. BACKGROUND AND CONVENING PROCESS In recognition of a growing interest in palliative care by clinicians, patients, and families, the Promoting Excellence in End-of-Life Care national program of The Robert Wood Johnson Foundation, in conjunction with the American College of Surgeons, created a national Peer Workgroup to facilitate introduction of the precepts and techniques of palliative care to surgical practice and education in the United States and Canada. The World Health Organization has defined palliative care as “The active total care of patients whose disease is not responsive to curative treatment.” The Surgeons Palliative Care Workgroup brought together surgeons with demonstrated interest and experience in palliative care to share resources, strategies, and expertise, and in so doing act as a catalyst for change. This is a summary of their analysis of the current state of palliative care in the surgical field and their recommendations. The full report will be released this summer by the Robert Wood Johnson Foundation. The Workgroup met during a 14-month period from September 2001 through November 2002. The initial Workgroup membership of 20 consisted of 17 surgeons representing 6 subspecialties, representatives of the executive and administrative staff of the American College of Surgeons, two recognized leaders in palliative care research and education, and a representative of the National Program Office of the Robert Wood Johnson Foundation. The Workgroup divided into seven subcommittees and conducted its business at four plenary sessions and periodic teleconferences. The Workgroup adopted the American College of Surgeons’ Statement of Principles Guiding Care at End of Life (1998) as its compass in the execution of its charge. After approval by the American College of Surgeons Board of Regents in October 2002, the Workgroup became integrated into the Division of Education of the American College of Surgeons as the Surgical Palliative Care Task Force.