This grant application proposes to provide web-based on-line information and knowledge resources to mental health professionals at the point of care, These resources include electronic documents and texts, databases, search engines, guidelines and any reference materials that are relevant to the decision-making process in patient care. The proliferation of errors in medical practice has been well publicized in recent years. Although the data on adverse events in psychiatry is less complete, there are numerous studies documenting the ways in which clinical practice deviates from acceptable standards. Access to timely information is often cited as on the proximal causes of error and substandard practices. Recent initiatives taken by the American Psychiatric Association, accrediting bodies, and affiliated mental health organizations to promote evidence-based medicine in the mental health profession have made available an unprecedented and rapidly growing pool of on-line resources such as clinical practice guidelines for physicians and nurses. We propose to integrate lnfobuttons manager technology with an existing electronic medical record system, Mental Health Automated Retrieval System (MHARS). lnfobuttons is a resource delivery system that has been implemented in clinical information systems at Columbia. It works by creating links within the EMR that passes the clinician's context to an application that matches the context to an information need, selects a resource for that need, formulates a query to that resource, passing the query to the resource, and displaying the results to the clinician. The result of the action is to open a browser window on the clinician's desktop with links in the forms of queries to context-sensitive Medline searches, guidelines and other pertinent documents.
The specific aims are: (1) Provide mental health professionals with access to guidelines and other resources in real time at point of care. (2) Adapt the lnfobuttons information resource delivery system to the field of mental health with an initial focus in the specific area of pharmacology. (3) Employ lnfobuttons Manager application in concert with the newly implemented electronic medical record system, Mental Health Automatic Retrieval System (MHARs) (4) Implement lnfobuttons in 4 representative institutions by the patient population served by the Office of Mental Health including: adult, child, forensic, and research institutions.
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