AI systems in clinical practice

Decision support systems
ERA
Early Referrals Application
Web-based decision support and cancer referrals system

developed by clinical domains keywords
Advanced Computation Laboratory, Cancer Research UK, London in collaboration with InferMed Ltd., London.  Cancer, early referrals Decision support systems, WWW
location commissioned status
GP practices linked to University Hospitals of Leicester NHS Trust 2001 Under clinical evaluation
description
The Early Referrals Application (ERA) is an interactive decision support tool to support General Practitioners in identifying those patients with suspected cancer that should be referred under the 2-week standard outlined by the Department of Health's "Referral Guidelines for Suspected Cancer".

ERA is intended to be used within the consultation so the workflow has been designed to be as simple as possible. During a typical user session (from first accessing ERA to making the referral) just four web pages will be encountered. The figure below illustrates the ERA workflow in terms of the web pages encountered by the user, with the central flow being the optimum route. These pages are clear and concise as the user must read and comprehend their content within the environment of the consultation. It also ensures that minimal time is spent interacting with ERA rather than the patient.

The design of the web pages have been influenced by the published guidelines, particularly with respect to the referral proformas. Where possible we have implemented the referral proformas' look and feel but, obviously, we have had to change some aspects to make the forms as computer friendly as possible and to collect information not represented on the referral proformas but necessary to make the decisions.

references
J Bury, M Humber, J Fox. Integrating Decision Support with Electronic Referrals Proceedings of the Tenth World Congress on Health and Medical Informatics (Medinfo2001), London, UK. September 2-5, 2001 " "
M Humber, H Butterworth, J Fox, R Thomson. Medical Decision Support via the Internet: PROforma and Solo. Proceedings of the Tenth World Congress on Health and Medical Informatics (Medinfo2001), London, UK. September 2-5, 2001 " "
Department of Health. Referral guidelines for suspected cancer. London: DoH, 2000.

[DoH]

"The Government White Paper entitled ‘The new NHS – Modern, Dependable’ guaranteed that everyone with suspected cancer will be able to see a specialist within two weeks of their GP deciding that they need to be seen urgently and requesting an appointment. ...
The aim of these guidelines is to facilitate appropriate referral between primary and secondary care for patients whom a GP suspects may have cancer. The guidelines should help GPs to identify those patients who are most likely to have cancer and who therefore require urgent assessment by a specialist. Equally it is hoped that the guidelines will help GPs to identify patients who are unlikely to have cancer and who may appropriately be observed in a primary care setting or who may require non-urgent referral to a hospital... "
contact links

John Fox
Advanced Computation Laboratory,
Cancer Research UK
PO Box 123
Lincoln's Inn Fields
London

E: john.foxatcancer.org.uk

 bullet  ERA demonstrator [OC]  bullet  ERA - case study (brochure, 2001)  bullet  ERA - press release from InferMed (2001)  bullet  Advanced Computation Laboratory  bullet  Cancer Research UK  bullet  InferMed Ltd
acknowledgements

Archive of AI systems in clinical practice previously administered by Enrico Coiera. Used with permission. Maintained and extended since 2001 by OpenClinical.

Entry on archive: 18 October 2001
Last main update: 18 October 2001
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