Diagnosis

Provision of Decision Support for Creating Differential Diagnoses and Directed History and Physicals

Scenario Details:  David is back in the clinic seeing Anna, a complex lung cancer patient with new edema apparently unrelated to either her lung resection or her chemotherapy. David is using a new Differential Diagnoses Tablet compatible with the hospital CDS infrastructure. He uses it as an aid in diagnosing difficult patients by entering the patient’s initial signs and symptoms into the small handheld tablet device. The tablet uses the DSS system to generate a list of possible initial diagnoses and also provides additional, highly targeted history questions and physical exam procedures as recommendations. As David completes these tasks and enters the results, the system begins refining the differential, dropping less likely diseases and reprioritizing the remainder. If the refinement of the diagnosis needs medical lab or other tests to provide needed data, the system suggests these as well. This iterative, continuously improving differential diagnoses list is displayed with estimated certainty predictions. At some point during the interview and exam, David is convinced that the probable diagnosis of glomerulonephritis is correct and he stops the exam. After reviewing the suggested treatment plan, he begins discussing his diagnosis with Anna and then prints the treatment plan for her to review at home.

Actors: Physician (David), Patient (Anna)

Requirements: