Updated: Aug 26, 1998
This is the most recent structured information on this project. Complementary data can be found on previous documents
PROMPT Protocols for Medical Procedures and Therapies

Overview

Purpose and objectives

The technology for capturing clinical guidelines and delivering decision support at the point of care is under development at the Imperial Cancer Research Fund, London. PROforma technology encompasses the lifecycle of clinical guideline computerisation, from design and implementation to execution. It consists of a graphical notation to support the initial structuring of the guideline, a formal knowledge representation language capable of capturing clinical guidelines in a form which can be interpreted by a computer, and software to execute guidelines defined using the PROforma method.

Central to the PROMPT workstation is the electronic patient record. A PC-based system was developed at the Institut Bergonié, Bordeaux during the DILEMMA project. Although built initially for use in the field of hospital cancer care, its design is generic to enable it to be used by health professionals in different clinical specialties. The PROMPT patient record has been successfully integrated with legacy systems, for example with a management system in a specialist hospital pneumology unit in Haut Lévêque, France. PICARD, an interface to the PROMPT patient record system customised for use by general practitioners has also been developed.

The patient record system also forms the basis of a pilot regional shared care health information network ('RISA') under development in south west France. The network aims to decentralise, expand and improve the co-ordination and quality of continuing care (particularly cancer) at regional and local levels. A communications infrastructure, based on the EDIFACT messaging standard has been implemented to link those health professionals participating in the network. France Telecom intranet technology supports secure data communications over the network. The RISA, which is expected to form part of the French national 'Réseau de Santé Social' project, is at the centre of a large scale project technology validation activity.

Results

• The component parts of the PROMPT care station, principally (i) PROforma and associated technology (decision support engine, protocol authoring tool) for the definition and implementation of clinical protocols, and its integration with external clinical applications; (ii) an electronic patient record system capable of use in different clinical sectors: primary care, shared care and specialist care; (iii) Edifact-based communications infrastructure;
• The Aquitaine health information telematics network centred on the Institut Bergonié, Bordeaux and covering health professionals in S.W. France;
• Clinical applications for primary care (including asthma, gastroenterology, hypertension) shared care and cancer care (including follow-up of breast cancer and colorectal cancer);
• A method for identifying, extracting and structuring clinical knowledge from hypertext guideline documents for the construction of knowledge bases for use in clinical decision support.

The Imperial Cancer Research Fund, London and Integral Solutions Ltd., Basingstoke have launched a new company, InferMed Ltd. (http://www.InferMed.com), to supply PROforma technology for general clinical use. In Bordeaux, Integrated Care Systems S.A. is commercialising the PROMPT electronic patient record system middleware.

List of deliverables

Year 1

• Requirements for primary, specialist and shared care M3 R
• Electronic patient record M3 R
• DSS/ protocol support engine - release 1 M3 R
• Enhanced Protocol Authoring Tool M6 R
• Definition of methodology (baseline study) for evaluation of clinical applications M6 R
• Clinical applications knowledge engineering manual M9 R
• DSS/ protocol support engine with integrated verification and validation tools M10 R
• Electronic patient record integrated with multimedia and knowledge based data management functionality M12 R

Year 2

• Applications development training manual M15 R
• Electronic patient record for use in primary and shared care M18 R
• Shared care telematics network M18 R

Year 3

• Exploitation plan M31 R
• Validation of PROMPT technology M36 R

List of participants

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