Expert system platform (ESP) and associated evidence-based knowledge modules: Antibiotic Assistant®, Public Health Surveillance Assistant™, Infection Control Assistant™, ADE Assistant™, Pain Management Assistant™, Clinical Alerts Assistant™.

TheraDoc, Inc.™ designs, implements and markets expert systems for clinical decision support.

TheraDoc provides clinicians with tools to help improve their ability to deliver high quality evidence-based care - reduce medical errors, improve treatment decisions, lower treatment costs and enhance quality and safety in patient care.

TheraDoc offers real-time, expert clinical decision support modules that can be used at the point of care or wherever required. Modules can be integrated with institutional and individual patient data on existing hospital information systems or used as standalone systems.

TheraDoc's products have largely grown out of the experience gained by its founders over a period of fifteen years' pioneering work in the development and implementation of integrated clinical decision support systems at LDS Hospital, Salt Lake City, Utah.

Computerised applications have been developed for a number of specialities including infection control, monitoring adverse drug events and integrated anti-microbial decision support.

Antibiotic Assistant®

The Antibiotic Assistant module integrates patient data with coded clinical data, global medical knowledge, institutional protocols and epidemiological factors, all of which are integrated with a hospital's legacy system. Through sophisticated knowledge-based engines, the software considers all possible ways in which an infectious disease can be managed and eliminates those options that are contra indicated due to mitigating factors (e.g. allergies, neutropenia) and patient attributes (e.g. height, weight, age).

TheraDoc knowledge-based engines analyze, as appropriate, any and all of the following to arrive at the best evidence-based recommendation:

• Site of Infection
• Microbial Spectrum of Activity
• Emergence of Microbial Resistance
• Epidemiologic Information
• Underlying Illnesses
• Vital Signs
• Laboratory and Radiology Results
• Cost of Treatment
• Appropriate Routes of Administration
• Appropriate Dosage Adjustments
• Duration of Therapy
• Drug Interactions
• Cross-resistance
• Allergieso Patient Compliance
• Insurance or Institutional Drug Formularies.

Public Health Surveillance Assistant™

Utilizing both patient-specific and population-based surveillance, TheraDoc's Public Health Surveillance Assistant uses data from multiple clinical sources including ADT, laboratory, pharmacy, radiology, nursing and other ancillary systems.

Utilizing standard HL7 message interfaces, the Surveillance Assistant integrates with existing legacy systems, leveraging an institution's previous investment in ancillary information systems. No special provider reporting, manual chart review or data entry is required with the TheraDoc system.

Observed signals and recognized patterns of signals collected and analyzed in real-time can help both institution-based and community-wide infection control units overcome the barriers to timely recognition of possible infectious outbreaks.

Infection Control Assistant™

TheraDoc technology continuously monitors and analyzes patient data from multiple sources, including the electronic medical record, pharmacy, laboratory, radiology, ADT and other electronic sources. Utilizing both patient-specific and population-based surveillance the Infection Control Assistant has the power to reason across these electronic databases and automatically capture events of interest, infer infection related events from clinical data, alert ICPs, and generate clinical and administrative reports.

The Infection Control Assistant includes the following standard features:

• Infection Surveillance & Reporting
• Notifiable Disease Surveillance & Reporting
• Isolation Surveillance & Management
• Exposure Management
• Automated Antibiogram
• Cluster Alerting
• Targeted Organism Surveillance
• Sentinel Organism-Drug Pairs Surveillance
• Surgical Site Infection Surveillance
• Surgical Prophylaxis Surveillance
• Quick Guides for Infections, Organisms & Isolation Precautions
• Preventative Health Surveillance
• Customized Reporting.

ADE Assistant™

TheraDoc's ADE Assistant uses data from multiple clinical sources including ADT, laboratory, pharmacy, radiology, nursing, and other ancillary systems. Using standard HL-7 message interfaces, the ADE Assistant integrates with existing information systems.

The TheraDoc ADE Assistant module includes the following features:

• Enhanced voluntary reporting interface
• Automated detection of ADEs through trigger-based signals
• Online causality assessment
• Online severity scoring
• Documentation of the drug causing the ADE
• Documentation of the clinical manifestation (result) of the ADE (e.g. rash, arrhythmia, bleeding, seizure, confusion)
• Automated archiving of reported ADEs, including storage of confirmed ADEs at the individual patient level similar to allergy documentationo Automated alerting on confirmed ADE history
• Flexible reporting tools for Pharmacy & Therapeutics Committee, JCAHO, etc.
• Optional automated reporting to the Food and Drug Administration Med Watch Program.

Pain Management Assistant™.

Using demographic and clinical data specific to each patient, the acute pain module assists clinicians in selecting an appropriate dose and schedule of both opioid and non-opioid analgesics for the treatment of acute pain. It includes recommendations for intravenous patient controlled analgesia, intermittent bolus dosing and oral administration.

The Pain Management Assistant contains an equianalgesic opioid dose converter. The dose converter allows the clinician to enter the total daily dose and route of administration of a patient's current opioid regimen and convert it to an equianalgesic dose of another opioid or opioid dosage form. The dose converter not only converts the patient's current therapy to an equianalgesic dose but also displays the converted dose as a specific generic prescription product, dosage form, dose and schedule. The recommended drug regimen can be printed for entry into physician orders or transcribed as a prescription for a patient to take to a pharmacy of their choice.

The Pain Management Assistant also includes support for the management of side effects. This module leads the clinician through a stepwise approach to the treatment of opioid-induced nausea and vomiting, constipation, sedation and respiratory depression. Using demographic and clinical data specific to each patient, the acute pain module assists clinicians in selecting an appropriate dose and schedule of both opioid and non-opioid analgesics for the treatment of acute pain. It includes recommendations for intravenous patient controlled analgesia, intermittent bolus dosing and oral administration.

The Pain Management Assistant contains an equianalgesic opioid dose converter. The dose converter allows the clinician to enter the total daily dose and route of administration of a patient's current opioid regimen and convert it to an equianalgesic dose of another opioid or opioid dosage form. The dose converter not only converts the patient's current therapy to an equianalgesic dose but also displays the converted dose as a specific generic prescription product, dosage form, dose and schedule. The recommended drug regimen can be printed for entry into physician orders or transcribed as a prescription for a patient to take to a pharmacy of their choice.

The Pain Management Assistant also includes support for the management of side effects. This module leads the clinician through a stepwise approach to the treatment of opioid-induced nausea and vomiting, constipation, sedation and respiratory depression.