Orlando Health rolls out decision support tool for 2,000 docs

By Bernie Monegain
10:40 AM

Orlando Health will implement a Web-based decision support checklist tool to assist physicians with diagnosis decisions.

The $1.7 billion not-for-profit healthcare organization with a community-based network of hospitals, tapped Isabel Healthcare for an automated system that it will make available to more than 2,000 physicians.

Orlando Health executives say the initiative is part of Orlando's commitment to quality and patient safety.

While most diagnoses are reached through the experience and knowledge of the physician, in 10 to 15 percent of cases they are more difficult to determine, according to industry reports. Isabel assists by accelerating the process for determining the diagnosis of a patient in those situations where there is some question.

The system is designed to complement the physician's expertise by producing a differential diagnosis checklist of those diagnoses most closely related to a given patient's clinical features. A patient's pertinent signs and symptoms are entered into the system and a differential diagnosis checklist is instantly returned. In addition, Isabel provides access to up-to-date information from medical journals and textbooks, hospital protocols, and online web resources.

"Missed information and delayed diagnosis can result in unnecessary testing and prolonged hospital stays, both of which can adversely affect patient care," said Jay Falk, MD, chief academic medical officer for Orlando Health. Isabel can be a powerful tool in helping to avoid these pitfalls while having the added benefit of helping to educate our physicians by broadening their differential diagnostic considerations."

The Isabel system was conceived 10 years ago as a direct response to the near-fatal misdiagnosis of a three-year-old girl in London named Isabel Maude, who developed necrotizing fasciitis, a complication of chicken pox. Both the girl's primary care physician and the local hospital's emergency department failed to recognize the typical clinical features of necrotizing fasciitis, a potentially fatal illness, and sent her home.

The girl's father, Jason Maude, founded Isabel Healthcare Inc. in 2000.

The Isabel system will be integrated into the health systems <a href="/directory/electronic-medical-record-emr" target="_blank" class="directory-item-link">electronic medical record system. This will allow Isabel to be used seamlessly in the clinical workflow of the physician.

"As always it is the responsibility of the CMIO to identify information systems that will support our clinical team in its endeavor to provide the best possible care for our patients," said Steve Margolis MD, chief medical informatics officer for Orlando Health. "In this circumstance it means providing our caregivers with the most informed, comprehensive and timely information that will assist and support the care of our patients. By integrating Isabel into the normal care process of our providers, we hope to accelerate the care of our patients as well as improve the efficiency and effectiveness of the care process itself."