Computing Problem Oriented Medical Records

Problem Oriented Medical Record (POMR) is a medical record approach that provides a quick and structured acquisition of the patient's history. POMR, unlike classical health records, focuses on patient's problems, their evolution, and the relations between the clinical events. This approach provides the physician a view of the patients' history as an orderly process to solve their problems, giving the opportunity to make explicit hypotheses and clinical decisions. Most efforts regarding POMR focus on the implementation of information systems as an alternative of classical health records. Results reveal that POMR information systems provide a better organisation of patients' information but unsuitable mechanisms to perform other basic issues (e.g. administrative reports). Due to its features, POMR can help to bridge the gap between the traditional clinical information process and knowledge management. Despite the potential advantages of POMR, only few efforts have been done to exploit its capacities as a knowledge representation model and a further automatic reasoning. In this work, we propose the Problem Flow, a computational model based on the POMR. This proposal has a double objective: (1) to make explicit the knowledge included in the POMR for reasoning purposes and (2) to allow the coexistence between classical health records and the POMR. We also present PLOW, a knowledge acquisition tool which supports the proposed model. We illustrate its application in the Intensive Care Unit domain.