A9:    Clinical decision support systems today and tomorrows state-of-the-art

Neill Jones MD Hon. Clinical Research Associate, Sowerby Centre for Health Informatics at Newcastle, University of Newcastle (UK) has extensive experience in general practice and in medical informatics. Amongst many positions, he is Membership Secretary of the Primary Health Care Specialist Group of the British Computer Society, Senior User Representative 1991 to 1997 NHS Centre for Coding and Classification, and has been involved in the MIQUEST project. He has a special interest in the mapping of information contained in different coding systems for use in decision support.

Nick Booth MD is Centre Director, Sowerby Centre for Health Informatics at Newcastle, University of Newcastle (UK) and a general practitioner who, since taking up his academic post at SCHIN, has been involved in the PRODIGY, Prestige, and COGENT decision support projects, several health messaging projects, including the TextBase project, and is an active member of CEN TC 251 Working groups I and II, in the fields of record architecture, messaging and continuity of care. His current main project work concerns Clinician – Patient – Computer interaction at the point of care (Information In the Consulting Room, NHS RDD ICT Grant), and the Durham EHR Project (NHS Information Authority funded – part of the ERDIP programme) to develop an architectural model for the NHS Electronic Health Record in England and Wales. He is currently immediate past chair of the Primary Health Care Specialist Group of the British Computer Society, and holds other significant national political appointments, including being a member of the Joint Computing Group of the BMA and Royal College of General Practitioners, a member of the Medical Information Group. He has been interested in clinical terminology and classification since 1991, was involved in the creation of the MIQUEST project and the formation of the Collection of GP Health Data projects, and is currently the UK representative on the World Organisation of Family Doctors International Classification Committee (WONCA) and a co-author of ICPC2 (the second edition of the International Classification of Primary Care), a member of the Strategic Steering Group of the NHS Centre for Coding and Classification, and is the UK Primary Care member of the joint SNOMED/Clinical Terms Editorial Board. He is an editorial adviser for the British Medical Journal, and a member of the advisory board of the British Medical Journal's Continuing Professional Development Institute. Nick also lectures widely, both nationally and internationally, on topics related to practical informatics in primary care.

Pete Johnson MD is an Hon. Clinical Research Associate, Sowerby Centre for Health Informatics at Newcastle, University of Newcastle (UK) worked for ten years in General Practice, while also writing software for the implementation of guidelines with one of the major GP system suppliers, and participating in two European projects on Decision Support in medicine - Dilemma and Prestige. He was the developer of the software for the conversion of the British National Formulary to electronic form, and the eBNF browser. In 1995-96 he spent the academic year as a visiting scholar at Stanford University, California in the Medical Informatics department, co-operating on guideline model development and drug information models. He has a special interest in decision support in primary care and the representation of drug knowledge, and has recently been working on Prodigy 3 and the Drug Ontology project.

Samson Tu is Senior Research Scientist, Stanford Medical Informatics, Stanford University School of Medicine (USA). His main research/professional interests are in the Modelling of clinical guidelines and protocols, knowledge-based systems, knowledge representation, databases, temporal database and temporal reasoning, protocol-based health care. His work has largely revolved around the development of knowledge-based systems that provide decision-support for guideline-based medical care. Currently his work is undertaken as part of the PROTEGE, EON, Intermed, ATHENA and other projects at Stanford. These projects are looking at protocols and guidelines in breast cancer care, diabetes and hypertension. He is looking at a component-based approach for creating a guideline modelling and execution architecture. The integrated system will include temporal extensions to the relational database formalism and the ability to make abstractions over temporal intervals.