Information Technology Reference
In-Depth Information
Fig. 4.3
Physicians Using Praxis Select the Most Appropriate Clinical Concepts for Each Patient
from Choices that Derive from their Most Similar Prior Cases.
Based on this idea the company developed what it calls a “concept processor”.
The computer science term for this is an artificial neural network (ANN). An ANN
is an advanced computing approach used to model complex relationships between
inputs and outputs or to find patterns in data. A bank, for example, might use an
ANN to find people who are more likely to be submitting fraudulent credit card
charges based on patterns that might not be obvious at all to a person looking at the
data, in part because of its massive scale. The technology is also being applied in
healthcare to look for fraudulent claims.
The basic idea behind Praxis is that physicians develop a method of going from
inputs - such as the history, physical exam and lab results - to outputs such as a
diagnosis and treatment plan. Praxis says that its concept processor “learns” how
each individual physician does this for the problems they see and uses that knowl-
edge to save the physician time on subsequent visits by essentially anticipating what
the physician will likely do and document. The system starts as a “blank slate” in
each practice but, over time, it gets better and better at finding the encounter closest
to the current one. After around 50 iterations of a particular problem the system is
well trained and, according to the company, can accurately find the closest matching
or even “identical” prior encounter. Based on that it brings up the clinical concepts
the physician has used in the past for similar patients, as illustrated in Fig.
4.3
. By
doing this the system saves the physician time and also serves to provide clinical
reminders, reducing the chance that something will be overlooked or forgotten.
Praxis has, laudably in my view, avoided the temptation to automatically document
for the physician who must specifically decide what to chart for each patient from
the list of concepts presented. The physician can, of course, add more or edit, as
appropriate for each case.
