title: Closing the loop: bringing decision support clinical data at the clinician desktop.
abstract: We describe the development of an inquiry office to bridge the gap between clinician needs for decision support systems and readily available large quantities of integrated clinical data. With this link, an information feedback mechanism is implemented that closes the loop of information flow by bringing decision support information from the data warehouse at the clinician desktop. As a result, and as a new DRG cost reimbursement system has been introduced, we have provided the heads of over 30 medical services with an intranet web-based application to access patient encoding of diagnoses, procedures, and DRGs of their respective service. The inquiry office has also developed a query service to process specific requests. It has implemented the automatic screening of patient clinical data of past and current hospitalizations in order to select cases for multiple studies, research, and teaching projects. The purpose of this clinical data warehouse and its information feedback process is to offer a coherent, comprehensive, and reliable return of information to improve decision making, to enable research projects, and to facilitate statistical outputs.
authors.affiliation: Service of Medical Informatics, University Hospitals of Geneva, Geneva, Switzerland. claudine.breant@sim.hcuge.ch
authors.forename: Claudine
authors.initials: C
authors.lastname: Bréant
authors.forename: Francois
authors.initials: F
authors.lastname: Borst
authors.forename: René
authors.initials: R
authors.lastname: Nkoulou
authors.forename: Olivier
authors.initials: O
authors.lastname: Irion
authors.forename: Antoine
authors.initials: A
authors.lastname: Geissbuhler
mesh_terms: D003195:Computer Communication Networks; D020000:Decision Support Systems, Clinical; D003953:Diagnosis-Related Groups; D005240:Feasibility Studies; D006751:Hospital Information Systems; D006801:Humans; D016247:Information Storage and Retrieval; D016347:Medical Records Systems, Computerized; D019095:Point-of-Care Systems; D018511:Systems Integration; D014584:User-Computer Interface