Clinical decision support, systems methodology, and telemedicine: their role in the management of chronic disease

In this paper, the design and evaluation of decision support systems, including those incorporating a telematic component, are considered. It is argued that effective design and evaluation are dependent upon the adoption of appropriate methodology set firmly within a systemic framework. Systems modeling is proposed as an approach to system design, with evaluation adopting an approach incorporating evaluability analysis and formative and summative evaluation, including the use of stakeholder matrix analysis. The relevance of such systemic methodology is demonstrated in the context of diabetes and end-stage renal disease as examples of the generic clinical problem of the management of chronic disease.

[1]  Ewart R. Carson,et al.  A methodology for assessing and evaluating information technology systems in diabetes care , 1997 .

[2]  R. Bashshur.  On the definition and evaluation of telemedicine. , 1995, Telemedicine journal : the official journal of the American Telemedicine Association.

[3]  Stafford Beer,et al.  The Viable System Model : its provenance , development , methodology and pathology * Stafford Beer = President of the World Organization for Systems and Cybernetics , 2000 .

[4]  Ewart R. Carson,et al.  Dealing with complexity: an introduction to the theory & applications of systemsscience , 1988 .

[5]  E. Carson,et al.  UTOPIA: a consultation system for visit-by-visit diabetes management. , 1996, Medical informatics = Medecine et informatique.

[6]  E. R. Carson,et al.  Assessing health policy strategies: a model-based approach to decision support , 1995, 1995 IEEE International Conference on Systems, Man and Cybernetics. Intelligent Systems for the 21st Century.

[7]  P Sönksen,et al.  Information technology in diabetes care 'Diabeta': 23 years of development and use of a computer-based record for diabetes care. , 1996, International journal of bio-medical computing.

[8]  F. del Pozo,et al.  Telemedicine for diabetes care: the DIABTel approach towards diabetes telecare. , 1996, Medical informatics = Medecine et informatique.

[9]  E R Carson,et al.  Decision support systems in diabetes: a systems perspective. , 1998, Computer methods and programs in biomedicine.

[10]  M. Malek,et al.  Setting priorities in health care , 1994 .

[11]  Ewart R. Carson,et al.  A systems methodology for the development and evaluation of a telematic home haemodialysis service , 1997, Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 'Magnificent Milestones and Emerging Opportunities in Medical Engineering' (Cat. No.97CH36136).

[12]  Ewart R. Carson,et al.  Dealing with Complexity , 1988, Springer US.

[13]  Colin Runciman,et al.  Perfect hash functions made parallel-Lazy functional programming on a distributed multiprocessor , 1993, [1993] Proceedings of the Twenty-sixth Hawaii International Conference on System Sciences.

[14]  E. Carson,et al.  Systems methodology, telemedicine and clinical decision support: their role in the management of chronic disease , 1997, Information Technology Applications in Biomedicine. ITAB '97. Proceedings of the IEEE Engineering in Medicine and Biology Society Region 8 International Conference.

[15]  Peter Checkland,et al.  Systems Thinking, Systems Practice , 1981 .