The Librarian Infobutton Tailoring Environment (LITE)

1. The Librarian Infobutton Tailoring Environment(LITE) James J. Cimino National Institutes of Health and Columbia University

2. Today’s Topics • Clinician Information Needs • Infobuttons • Infobutton Managers • The Coumadin Story • Institution-Specific Requirements • Infobutton Manager Customization Tasks • Librarian Infobutton Tailoring Environment • Research plan • Initial efforts • Getting involved

3. Health Knowledge for Decision Support

4. Infobuttons Anticipate Need and Provide Queries i

5. Information Needs of CIS Users • Common tasks may have common needs • System knows: • Who the user is • Who the patient is • What the user is doing • What information the user is looking at • We can predict the specific need • User is sitting at a computer! • We can automate information retrieval

6. First Attempt: The Medline Button • CIS on mainframe • BRS/Colleague (Medline) on same mainframe • Get them to talk to each other • Search using diagnoses and procedures

11. First Attempt: The Medline Button • CIS on mainframe • BRS/Colleague (Medline) on same mainframe • Get them to talk to each other • Search using diagnoses and procedures • Technical success • Practical failure

12. Education at the Moment of Need MRSA

13. Education at the Moment of Need 1 MRSA Understand Information Needs

14. Education at the Moment of Need 2 Get Information From EMR 1 MRSA Understand Information Needs

15. Education at the Moment of Need 2 Get Information From EMR 1 MRSA Understand Information Needs 3 Resource Selection

16. Education at the Moment of Need 4 2 Get Information From EMR Resource Terminology 1 MRSA Understand Information Needs 3 Resource Selection

17. Education at the Moment of Need 4 5 2 Automated Translation Get Information From EMR Resource Terminology 1 MRSA Understand Information Needs 3 Resource Selection

18. Education at the Moment of Need 4 5 2 Automated Translation Get Information From EMR Resource Terminology 6 1 MRSA Querying Understand Information Needs 3 Resource Selection

19. Education at the Moment of Need 4 5 2 Automated Translation Get Information From EMR Resource Terminology 6 1 MRSA Querying Understand Information Needs 3 7 Resource Selection Presentation

20. Research Issues • What are the information needs? • Which context information is important? • What resources can satisfy needs? • How can retrieval be automated? • What context data are used? • How are the data translated?

31. Infobuttons vs. Infobutton Manager Resource s Clinical System Infobutton Context Query Knowledge Base Infobutton Manager Page of Hyperlinks

39. The Coumadin Story • Chair of Medicine wants link to Coumadin protocol • First, I have to find the guidelines

41. The Coumadin Story • Chair of Medicine wants link to Coumadin protocol • First, I have to find the guidelines • Then I have to add the question to the IM table

43. The Coumadin Story • Chair of Medicine wants link to Coumadin protocol • First, I have to find the guidelines • Then I have to add the question to the IM table • Finally, I link the question to the context

45. The Coumadin Story • Chair of Medicine wants link to Coumadin protocol • First, I have to find the guidelines • Then I have to add the question to the IM table • Finally, I link the question to the context • Voilá!

49. Usage in Lab Contexts

50. Usage in In-Patient Drug Contexts