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About the Digital Clinician©

Retrospective computer-assisted diagnostics for both triage at points of entry to the healthcare system and third-party management of all cases along clinical pathways - or, Disease Specific Management - generated one of the fastest growing industries in the United States in computerized clinical decision support.  This trend towards computer-assisted diagnosis is inevitable, despite the costly failures in the past and contemporary problems of provider-vendor mal-alignment of needs and perceived benefits.  If computer-assisted Work-up and Interview Support can be efficiently utilized by primary care clinicians, Diagnostic Support Systems could be the hub generating more valid clinical pathways that optimize healthcare service.  In the right hands, more valid, managed clinical pathways would likely improve reliability of their descendant Disease Specific Management, rendering conflicts between providers and their patients, payers, pharmacists and plaintiff attorneys less contestable. 
Time-determined decision-making is the clinical discipline of prioritizing presentations for selection of who is seen first and for how much time to minimize morbidity, mortality and cost – or, Service Optimization – for either a single patient or an entire gateway into the healthcare system.
Epidemiolgically – informed decision-making is the clinical discipline of reducing invalid diagnoses within time constraints utilizing knowledge of the likelihood for certain presentations within a particular gateway at a particular time.

Currently time-determined and epidemiolgically-informed clinical decision-making are learned via clinical practice rather than formal clinical training.  The exception to this is EMS health professional education and Emergency Medicine Residency training for “The Red Zone”.  These skills for most frontline clinicians, therefore, are built almost exclusively upon intuitive capabilities of practitioner experience.   Effective ER Triage nurses and point-of-entry primary care physicians serve as operational examples of these highly developed intuitive skills.

Distant education is likewise growing rapidly, and time-determined, epidemiologically informed point-of-entry clinical decision-making for all triage personnel, including most physicians and nurses - as well as all EMS health professionals - will be necessary to support the inevitable health services information technology revolution in the first decade of new millennium.  The events of 9/11 have spurred The Office of Health Research Quality of  The Department of Health and Human Services into a leadership role in this inevitable transformation of healthcare services, as highlighted by their terrorism initiatives and focus on high risk populations and regions.

DX/RX

The Digital Clinician®

Can Effect Improved Diagnostics

to

Better Originate

Clinical Pathways that

Promote Better Patient Care

Supported by

Valid Documentation of

Clinical Work

at

All Points of Care

For:
Telehealth Presentations: Forefront TeleCare, Inc

Interview Support and Workup for Electronic Health Record:                          Dr Antonia Arnaert, McGillUniversity Telenursing R&D

Distant Education for Healthcare Professionals: Challenger Corporation: WWW.chall .com & EMPsych

The Digital Clinician® is an Expert System that uses artificial intelligence to match the rules and knowledge base of Triage with the rapidly changing and multiform presentations of clinical encounters.  Whether the encounter is a real or simulated Prehospital, Acute Outpatient or Inpatient case, The Digital Clinician® supports the clinician in Working Smart.  To work smart, the clinician must screen clinical presentations based on both severity and likelihood.  The odds for enhancing diagnostic validity within any population, whether that of personal care or mass casualties is thereby increased.   And, with a Mass Casualty Incident, effective and non-prejudicial Triage is mandatory under International Law.

It has been proven that every clinician requires considerably more information than is stored within the best of clinical minds.  The current threat from this knowledge gap is escalating due to expected surges of multiple patients from acts of terrorism.  And this threat is occurring within a concurrent healthcare environment of increasing delegation of clinical responsibilities to professionals with less training.  The interactive process between clinician and The Digital Clinician®, whether it is embedded for

can fill that knowledge gap.  And, by doing so, it can enhance provider effectiveness, legal safety, cash flow and staffing decisions for surges of unknown patients at any point of care, whether for personal care or Population-based Triage of  Mass Casualty Incidents.

Ref. Liebert, JA, “Unity in Healthcare The Toyota Way: Can Lean Engineering Fix North American Health Care?”, King County Medical Society Bulletin, February 2008