Research at the doctor's fingertips
Providing practitioners with patient-specific advice based on the latest clinical guidelines can improve the quality and efficiency of public healthcare. A new association of system users and suppliers will speed EU take-up of this technology. Background With public authority support, national and international expert groups are developing guidelines to cover a growing range of medical scenarios, from the management of diabetes to the administration of anticoagulant therapy. To be useful, such guidelines must be studied and absorbed by individual doctors, and interpreted in relation to specific cases. Therefore, it can be several years before they are widely implemented. Such delays cost money, and may even cost lives. Many doctors already use computer networks to store and retrieve patient records and to share information with colleagues. The "Prestige" project developed a technology which employs this infrastructure to deliver clinical advice relevant to the treatment of specific patients. Now the project's 30 partners have launched an open membership organisation to provide an on-going forum for the exchange of experience in this field. Description, impact and results The market did not want another comprehensive new technology. Existing computer systems represent a huge investment by health authorities. Prestige designed software components which can be integrated with these systems, allowing any guideline to be made available on any hardware platform, and to be tailored to local needs. One British angina system is already attracting growing support from staff on two hospital sites. When a patient is referred to the cardiology outpatient clinic, Prestige software displays the care pathways taken to date, shows the current options, and prompts the clinician to collect or review the data necessary for a sound clinical assessment. The Prestige Association, formally launched in Lisbon on 17 March this year, aims to build on the success of these pilots. By promoting the use of the technology among national healthcare services, it hopes to ensure that, in future, European doctors are never more than a mouse-click away from the latest research findings. Working partnerships The three-year project, supported by the EC's Telematics Applications Programme, involved partners from eight countries - medical associations, primary healthcare authorities and individual hospitals, academic partners, and companies with existing medical informatics products - as well as international bodies. The breadth of the partnership was essential in order to create a technology which could be applied generally to healthcare sectors and medical specialities, and across national boundaries. The project devised a standard format for representing clinical knowledge content in computer-readable form, and developed an authoring tool enabling a guideline's printed text to be accurately transcribed into this format. Finally, pilot applications were built by different groups of partners to test the new technology's capacity to meet a range of technical and medical needs.