title: Towards a decision support system for optimising clinical pathways of elderly patients in an emergency department.
abstract: Data stored in Healthcare Information Systems correspond potentially to a vast source of information for supporting decisions in management or public health issues. The presented study illustrates clinical data valuation, through the analysis of clinical pathways of elderly patients at the Emergency Department (ED) of Rennes hospital.
  
  
  METHODS
  Relevant data were extracted from the Emergency Department database. Several analysis (e.g., cusum method) and representation tools (e.g., Graphviz) were used to study the patients' pathways, the dynamics of flows and the patients' characteristics.
  
  
  RESULTS
  4951 admissions were analysed and visualized. The representations provided a synthetic, global and comprehensive view of the department activities, to the satisfaction of the clinicians. Limitations of the ICD-10 coding of the diagnoses at the ED were pointed out as well as syntax and semantic interoperability issues. A solution is proposed for automating and scaling the Decision Support System.
authors.affiliation: EA3888, Faculté de Médecine, Université de Rennes1, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Cuggia
authors.forename: Delphine
authors.initials: D
authors.lastname: Rossille
authors.forename: Aude
authors.initials: A
authors.lastname: Arnault
authors.forename: Jacques
authors.initials: J
authors.lastname: Bouget
authors.forename: Pierre
authors.initials: P
authors.lastname: Le Beux
mesh_terms: D000368:Aged; D019091:Critical Pathways; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D038801:International Classification of Diseases; D007902:Length of Stay; D017410:Practice Guidelines as Topic