Page 255 - DCAP208_Management Support Systems

Management Support Systems

Notes

Case Study Developing Healthcare Rule-based Expert Systems

he use of expert systems to generate automated alerts and patient instructions
based on telemonitoring data could enable increased self-care and improve clinical
Tmanagement. However, of great importance is the development of the rule set to
ensure safe and clinically relevant alerts and instructions are sent. The purpose of this
work was to develop a rule-based expert system for a heart failure mobile phone-based
telemonitoring system, to evaluate the expert system, and to generalize the lessons learned
from the development process for use in other healthcare applications.
Methods
Semi-structured interviews were conducted with 10 heart failure clinicians to inform the
development of a draft heart failure rule set for alerts and patient instructions. The draft
rule set was validated and refined with 9 additional interviews with heart failure clinicians.
Finally, the clinical champion of the project vetted the rule set. The concerns voiced by the
clinicians during the interviews were noted, and methods to mitigate these concerns were
employed. The rule set was then evaluated as part of a 6-month randomized controlled
trial of a mobile phone-based heart failure telemonitoring system (n=50 for each of the
telemonitoring and control groups).
Results
The developed expert system generated alerts and instructions based on the patient’s
weight, blood pressure, heart rate, and symptoms. During the trial, 1620 alerts were
generated, which led to various clinical actions including 105 medication changes/
instructions. The findings from the trial indicated the rule set was associated with improved
quality of life and self-care.
Conclusions

A rule set was developed with extensive input by heart failure clinicians. The results from
the trial indicated the rule set was associated with significantly increased self-care and
improved the clinical management of heart failure. The developed rule set can be used as
a basis for other heart failure telemonitoring systems, but should be validated and modified
as necessary. In addition, the process used to develop the rule set can be generalized and
applied to create robust and complete rule sets for other healthcare expert systems.
Question

Discuss the development of a rule set.
Source: http://www.ncbi.nlm.nih.gov/pubmed/22465288

14.3 Summary

AI is a field of study that encompasses computational techniques for performing tasks that
apparently require intelligence when performed by humans.

The Turing Test, proposed by Alan Turing, was designed to provide a satisfactory
operational definition of intelligence.
Expert system is programs that attempt to perform the duty of an expert in the problem
domain in which it is defined.

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