AN INTEGRATED APPROACH FOR A KNOWLEDGE-BASED CLINICAL WORKSTATION - ARCHITECTURE AND EXPERIENCE

Today, the demand for medical decision support to improve the quality of patient care and to reduce costs in health services is generally re cognized. Nevertheless, decision support is not yet established in dai ly routine within hospital information systems which often show a hete rogeneous architecture but offer possibilities of interoperability. Cu rrently, the integration of decision support functions into clinical w orkstations is the most promising way. Therefore, we first discuss asp ects of integrating decision support into clinical workstations includ ing clinical needs, integration of database and knowledge base, knowle dge sharing and reuse and the role of standardized terminology. In add ition, we draw up functional requirements to support the physician dea ling with patient care, medical research and administrative tasks. As a consequence, we propose a general architecture of an integrated know ledge-based clinical workstation, Based on an example application we d iscuss our experiences concerning clinical applicability and relevance . We show that, although our approach promotes the integration of deci sion support into hospital information systems, the success of decisio n support depends above all on an adequate transformation of clinical needs.