What provides the smarts behind an advanced implementation of electronic health records? Clinical decision support systems. It may be time to revisit your CDS vendor options.
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Developed at the Laboratory of Computer Science at Massachusetts General Hospital in Boston, DXplain has been in use since 1986 and marketed nationally since 1987. Over the years, the knowledge base has grown from about 500 diseases in the first release to more than 2,400 diseases, 5,000 clinical findings, and 230,000 data points, according to Mass General, which still holds the distribution rights.
Users enter clinical information into a text box, then the diagnostic decision support system looks for appropriate medical evidence in its knowledge base, looking for synonyms and correcting misspellings to account for the wide variations that free-text entry presents. DXplain offers a list of possible diagnoses based on symptoms, physician observations, test results, and other factors. Physicians can click a "Focus" button to emphasize some findings over others in reaching a diagnosis.
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