RetroGuide
RetroGuide is a name of a research project in medical informatics (or more precisely clinical informatics) focusing on using workflow technology in healthcare. In 2009, RetroGuide became a component in a larger project/system called HealthFlow
This is an ongoing project. Several past phases could be described. Initial phase was at Intermountain Health Care in Utah, USA and happened during 2004-2007. The main mode was retrospective use. The development continues at Marshfield Clinic (Marshfield Clinic Biomedical Informatics Research Center) during 2008-2010. The prospective version of the RetroGuide system has been developed (called FlowGuide) and the overal system which is using a workflow engine within an EHR system is called HealthFlow [1].
RetroGuide uses a flowchart paradigm to represent knowledge. Knowledge represented can be a prospective alert logic or retrospective EHR query question.
RetroGuide has been used on several clinical problems
- investigating blood pressure control in diabetics patients
- investigating pregnancy rate in female patients after treatment of Hodgkin lymphoma
- investigating HEDIS quality improvement measures from NCQA
- osteoporosis measure (OMW)
- cholesterol control in cardiovascular patients (CMC)
- investigating alternative glucose protocol logic for blood glucose control in ICU patients
- course of care for diabetes
- course of care for AMI
- course of care for chronic kidney disease
- detecting adverse drug events (respiratory failure after use of narcotics, Naloxone)
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[edit] Evaluation
RetroGuide graphical approach to model queries has been formally evaluated in a study involving 18 human subjects with limited database expertise [2]. The study compared RetroGuide technology with SQL. Each subject had to solve 14 analytical tasks using both compared technologies. The qualitative comparison of average test scores showed that the study subjects achieved significantly higher scores using the RG technology.
Each subject also filled a follow-up questionnaire which compared both technologies qualitatively. The results of this qualitative study showed that 94% of subjects preferred RG to SQL because RetroGuide was easier to learn, it better supported temporal tasks, and it seemed to be a more logical modeling paradigm. The second part of the follow-up qualitative questionnaire also asked RG-specific questions based on validated constructs from the Unified Theory of Acceptance and Use of Technology. The results of this second part suggested that a fully developed, RetroGuide-like technology would be well accepted by users.
[edit] References
- ^ Huser, V.; Rasmussen, L. V.; Oberg, R.; Starren, J. B. (2011). "Implementation of workflow engine technology to deliver basic clinical decision support functionality". BMC Medical Research Methodology 11: 43. doi:10.1186/1471-2288-11-43. PMC 3079703. PMID 21477364. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3079703.
- ^ "PhD dissertation: Chapter 5: RetroGuide evaluation study". http://content.lib.utah.edu/u?/ir-main,13344.
[edit] Scientific Articles
- Huser V, Rocha RA, James BC, "Use of Workflow Technology Tools to Analyze Medical Data," pp. 455-460, 19th IEEE Symposium on Computer-Based Medical Systems (CBMS'06), 2006. article (doi)
- Huser V, "Running Decision Support Logic Retrospectively to Determine Guideline Adherence: a Case Study With Diabetes," Spring AMIA2007 symposium poster conference
- Huser V, Rocha, RA, "Analyzing medical data from multi-hospital healthcare information system using graphical flowchart models," BMIC Symposium, Orlando, 2007 (accepted).
- Huser V, Rocha RA, Huser M, "Conducting Time Series Analyses on Large Data Sets: a Case Study With Lymphoma," Medinfo 2007, Brisbane, 2007.
- Huser V, Rocha RA, "Retrospective Analysis of the Electronic Health Record of Patients Enrolled in a Computerized Glucose Management Protocol," CBMS 2007 DOI link
- Huser V, Rocha RA, "Graphical Modeling of HEDIS Quality Measures and Prototyping of Related Decision Support Rules to Accelerate Improvement", AMIA Fall Symposium, 2007, Chicago, USA poster
- Huser V, Rocha RA, "Graphical Modeling of HEDIS Quality Measures and Prototyping of Related Decision Support Rules to Accelerate Improvement", AMIA Fall Symposium, 2007, Chicago, USA poster
- Huser V, Peissig PL, Christensen CA, Starren JB. Evaluation of commercial workflow engine for modeling clinical processes in quality improvement and decision support. Proc of 15th Annual HMO Research Network Conference 2009.
- Huser V, Rocha RA, Narus SP. Evaluation of a flowchart-based EHR query system: a case study of RetroGuide. J Biomed Inform 2009;ePub ahead of print PubMed DOI link
- Huser V, Rasmussen L, Starren JB. Representing clinical processes in XML process definition language (XPDL). AMIA Spring Symp 2009.
- Huser V, Starren JB. EHR Data Pre-processing Facilitating Process Mining: an Application to Chronic Kidney Disease. AMIA Annu Symp Proc 2009 (accepted) 2009.
