The Future is Here:An Open Architecture Resource

to Support Infobuttons

James J. CiminoNIH Clinical Center and

National Library of Medicine

Infobuttons

• Context-aware links between systems

• Typically: connection from clinical information system to on-line knowledge source

• The Web lowered many barriers

• HL7 Standard is lowering more

Infobuttons vs. Infobutton Manager

Pageof

Hyperlinks

InfobuttonClinical System Resource

InfobuttonManager

ContextQuery

KnowledgeBase

s

www.infobuttons.com

www.infobuttons.org

Open Infobutton

• Hl7-compliant Infobutton Manager

• Supports access to HL7 and non-HL7 resources

• Housed at University of Utah (Guilerhme Del Fiol)

• Free for use

www.openinfobuttons.org

Institution Customization Tasks

i

Clinical Applicationwith Infobutton Link

User (Physician,Nurse, etc.)

Patient (with ageand gender)

Institution

InfobuttonManager

Page of Links

Infobutton ManagerKnowledge Base

Institutional Librarian(or other LITE users)

The Librarian InfobuttonTailoring Environment

(LITE)

Librarian Infobutton Tailoring Environment

• Co-developed by NLM and U of Utah

• Infobutton Manager knowledge engineering tool

• Librarian-friendly user interface– Define resources– Select resources for specific user contexts

• “Publishes” to Open Infobutton

• Currently in development, beta release Q1 2012

lite.bmi.utah.edu

Clinical Data Capture and Infobuttons

• Clinical data determine context of information need

• Controlled terms may need transformation for information needs

• Clinical data used to seed retrieval process

• Controlled terms may need translation for resources

Other Translations for Infobuttons

InjectableGentamicin

Gentamicn Sensitivity

Test

SerumGentamicin

Level

GentamicinToxicity

Gentamicin DecisionRule

ExpertSystem

DrugInformation

Clinical Data

Pushing the Envelope

HealthRecord

DischargeDiagnoses

MedicationLists

RadiologyReports

PhysicalExams

DischargeSummaries

PatientHistories

UniversallyCoded

LocallyCoded

UncodedStructured

UncodedUnstructured

Pushing the Envelope

HealthRecord

DischargeDiagnoses

MedicationLists

RadiologyReports

PhysicalExams

DischargeSummaries

PatientHistories

UniversallyCoded

LocallyCoded

UncodedStructured

UncodedUnstructured

Pushing the Envelope

Cimino JJ: Data Storage and Knowledge Representation for Clinical Workstations. International Journal of Bio-Medical Computing, 1994; 34:185-194

HealthRecord

DischargeDiagnoses

MedicationLists

RadiologyReports

PhysicalExams

DischargeSummaries

PatientHistories

UniversallyCoded

LocallyCoded

UncodedStructured

UncodedUnstructured

Cimino JJ: Data Storage and Knowledge Representation for Clinical Workstations. International Journal of Bio-Medical Computing, 1994; 34:185-194

HealthRecord

DischargeDiagnoses

MedicationLists

RadiologyReports

PhysicalExams

DischargeSummaries

PatientHistories

UniversallyCoded

LocallyCoded

UncodedStructured

UncodedUnstructured

Pushing the Envelope

Cimino JJ: Data Storage and Knowledge Representation for Clinical Workstations. International Journal of Bio-Medical Computing, 1994; 34:185-194

Conclusions

• Decision support is more than alerts and reminders

• Infobuttons require actionable clinical data

• Infrastructure is near to allow everyone to play

• Free!

• Infobuttons = Meaningful Use