| Introduction to Decision Support Tools
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- Key Questions
- What kinds of decisions do physicians make?
- What kinds of "tools" are commonly used to support
these decisions?
- What information do physicians need to use these tools?
- How does information get too the physician and from the
physician to the tool?
- What are the types of decision support tools?
- Treatment focused: tools that give only treatment information
- Diagnosis focused: tools that give only diagnosis related
information
- Patient focused: tools that give patient specific information
- Patient independent: tools that integrate disease and treatment
information (but not for specific patients)
- Diagnosis independent: tools that recommend treatment for
a specific patient
- Treatment independent: tools that propose diagnoses for
a specific patient
- Classic references about physician behavior and decision support
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| Security and Confidentiality
Issues |
- It is easier to steal one paper record than one electronic record.
- It is easier to steal one million electronic records than one
million paper records (and worth more).
- When you accept an "account" from a hospital, you
become accountable. Your risk is that the hospital will prosecute
YOU if ANYONE misuses your account.
- Patient medical record numbers use to be the same as the social
security number. They were changed for a reason. They still need
to be kept as secure as if you had the patient's social security
number.
- Passwords
- Random passwords are bad because people write them down.
- Plain english words are bad because crackers use electronic
dictionaries to check words inEnglish or other languages.
- Personal information (name, name backwards, car license
plate number, spouse's name, birth dates) are bad because
someone who can discover that information can also try it.
- A relatively secure password would be two short words with
a number or punctuation mark in the middle (eg. "he8figs"
but don't use this one now; it is no longer secure!).
- Taking the first letters of a phrase also works well (eg
"tm2lnp" as in "take me 2 lunch now please"; this is no longer secure either).
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| Search problems that apply to many types of databases. |
- Search on the most obscure piece of information first. For example,
don't search for all "white" pills when you can search
for all "barrel-shaped" pills.
- Watch out for vocabulary problems (eg. "geltab" vs
"gelatin" vs "soft-gelatin" OR "renal
cell carcinoma" vs "renal pelvis cancer" vs "kidney
(renal cell) cancer").
- Use the right database for the right question.
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Start Case
Internal Medicine Clerkship
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