Workflow Support

Provision of Workflow-Centric Decision Support

Scenario Details: Following Anna’s visit, David has a few minutes before his next patient. He notices that he has several messages in his universal inbox. Accessing it quickly from within the hospital EMR, David reads new emails from the quality manager, the department chairman, and a note from his wife. He sees that he has several from patients as well, including device data from Celia, a complex diabetic he is following closely. Selecting her message, the system graphs a week’s worth of glucometer readings, including the dietary log he asked Celia to record - he notes that her glucose control is much better, but not perfect. The CDS system presents a recommendation to increase her evening Lente dose to help correct her morning values. Before agreeing, he deletes some values that appeared to be clearly erroneous. The CDS system recalculates its recommendation, but doesn’t adjust the new Lente dose it recommends. Satisfied that the system is using the best data, and agreeing that the recommendation is justified, he authorizes the dose adjustment. The system then presents a draft notification email to Celia that explains the reasoning for the adjustment. David notes with satisfaction that it is written at the high school reading level versus the 7^th grade default, as he has configured Celia’s correspondence to be set at a higher level.  He adds a personal note, making sure to congratulate her on grandson’s recent graduation from high school, an event she mentioned several months ago as being important to her. He sends the email, stores the medical device readings as “self-reported” data in the EMR, signs off on a few dictations that need his signature, and prepares to see his next patient.

Actors: Physician (David), Patient (Celia)

Requirements: