THE MEDICAL FOLDER AS AN ACTIVE TOOL IN DEFINING THE CLINICAL DECISION-MAKING PROCESS

Whenever the user of a consultation system needs to know a large amoun t of information items that are possibly inter-related, a system that is able to cooperate with the user can simplify the interaction and in crease its speed. In fact, these systems can recognize the goals of th e user, individuate the information related to his goals, and finally focus their attention on this information [1]. This paper describes re search work on the design and creation of a medical folder management system capable of establishing cooperative dialogue with users who hav e access to the information contained therein. Particular attention ha s thus been paid to the problems of man-computer dialogue and user mod els. The research work has addressed the problem of integrating into t he system knowledge about the medical domain and users (physicians are only used for the time being), which are both necessary to activate a cooperative dialogue. After analysing the literature on the problems of user models, this paper presents and formalizes a study performed a t the IVth Surgical Clinic of the Pome University Umberto I General Ho spital to identify and represent how, when, and with what goals the ph ysician consults the medical folder, as well as the dialogue procedure s he normally adopts. The paper also illustrates important characteris tics of the CADMIO prototype, which has been developed since the study was made. CADMIO stores information about users for use in recognizin g and interpreting their behaviour, providing help, and in acquiring a nd returning further information. Whilst always bearing in mind the ph ysician's pre-established goals, it structures information to facilita te his consultation activity, offering him options for the retrieval o f further information semantically linked to that already obtained.