FIGURE 5.1. The virtual patient—a component view of systems-supported, evidence-based practice.


The virtual patient—a component view of systems-supported, evidence-based practice.

The left side of the figure concerns patient care. Raw data about a patient (the electronic health record) constitute the foundational base. Next come the transactional systems that both produce and use raw data as health care is provided. These two components make up the majority of today’s health care IT. Above them, the committee envisions a computational model of the virtual patient.

The right side of the figure represents biomedical science and research and its integral role in health care. Again, raw research data about biological and medical phenomena are at the base. Clinical research transactional systems add to and use raw data during the process of executing or running clinical research protocols. At the top are the models and abstractions that constitute biomedical knowledge. The thread connecting the top three components is what might be called medical logic.

Mapping from medical logic to cognitive decision support is the process of applying general knowledge to a care process and then to a specific patient and his or her medical condition(s). This mapping involves workflow modeling and support, usability, cognitive support, and computer-supported cooperative work and is influenced by many non-medical factors, such as resource constraints (cost-effectiveness analysis, value of information), patient values and preferences, cost, time, and so on.

The virtual patient poses the greatest research challenge but is only one component. Smooth integration with other components is the goal.

From: 5, Research Challenges

Cover of Computational Technology for Effective Health Care
Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions.
National Research Council (US) Committee on Engaging the Computer Science Research Community in Health Care Informatics; Stead WW, Lin HS, editors.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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