Dimension of time in illness: An objective view

It is almost impossible to try to represent acid analyze clinical data in t he absence of a temporal dimension. The temporal aspect is especially impor tant when automated decision support is used for patient care over substant ial periods. This paper emphasizes the crucial role that tasks of temporal reasoning and temporal maintenance play in modern medical information and d ecision support systems; it also discusses the implications of providing au tomated support to clinicians who must perform such tasks as part of broade r clinical tasks (for example, monitoring and therapy). Temporal reasoning tasks mainly involve intelligent analysis of time-oriented clinical data, a nd temporal maintenance tasks focus on effective storage and retrieval of t hese data. Both types of tasks, however, are highly relevant for such appli cations as patient monitoring, proper use of therapeutic guidelines, assess ment of the quality of guideline use, and visualization and exploration of time-oriented biomedical data. Scientists in medical informatics should vie w the integration of these two areas as a major research and development go al. This paper demonstrates one approach to integration by presenting the c oncept of a temporal mediator, which combines temporal reasoning and tempor al maintenance. Use of the temporal mediator in several clinical tasks is a lso presented and discussed.