ProPath - A guideline based software for the implementation into the medical environment: General Overview about Guideline based Medical Information or Expert Systems and their Relation to Clinical Pathways

Over the last decades, the amount of medical information has been growing rapidly. Online platforms such as patient's and doctor's blogs and forums and medical databases are widely and easily accessible to medical professionals as well as to the public. However, researching, filtering and evaluating the quality of this often overwhelming amount of data remains a challenge. Moreover, existing guidelines in the medical context are extensive and hardly applicable in the clinical context since reading and translation into clinical practice is time consuming [1][2]. Due to growing critical awareness among patients towards their medical treatment, there is an increased demand from internists, general practitioners, and other specialists, to explain medical conditions, treatment options and procedures in a more comprehensive fashion. In addition this discussion should be supported by the current state of clinical research. Expert systems could provide valuable support to fulfill these needs. Initial prototypes of expert systems in the inpatient arena were already implemented in the 1960's in the context of clinical trials [3]. The main goal of these systems was to improve medical care by assisting in the medical decision process. However, most of these systems did not remain in clinical practice for a prolonged period of time. In most cases, the user interface of the software was too complex for daily use. Appropriate application and a detailed insight into these systems requires a lot of handbook knowledge. Therefore the initial hurdles for the integration of software into specific clinical application, faced by the potential users were too cumbersome. The main purpose of the project ProPath was to eliminate these issues and at the same time provide optimal clinical practice for the health care system in a variety of medical topics. Both in the outpatient and inpatient scenario, there is an increasing demand to support communication and to improve the distribution of published knowledge and the application of practical experiences within the medical field. The main challenge to achieve that objective is to design an intuitive, user friendly software product that can be integrated into the current standard network environments. An example of successful implementation of a medical information system into clinical practice is the PROP system [4]. It is a medical decision support system, which has been designed, developed and implemented in Austria in the course of Reformpoolprojekt, in order to optimize the preoperative process. Since 2008, it is applied by general practicioners, pediatricians, clinicians and internists, in the state of Salzburg and was externally evaluated by the Paracelsus Medical University (PMU) in Salzburg. This paper provides an overview on how acquired knowledge can be utilized to reduce the complexity of designing and implementing clinical pathways (ProPath), supported by medical information or expert systems. Finally, statistical results evaluating PROP user-behavior are described. © 2014 IEEE.