A comprehensive approach to the IT: Clinical practice interface

Abstract

Medicine in the twenty-first Century is beset with two fundamental problems. Everyday care is poor quality care. And clinical research programs do not provide consistent answers to pressing clinical questions. Both problems affect individual lives and contribute to a system of health care that is not sustainable financially. Poor quality health care drives cost because most health care expenditures are for treating expensive, hard-to-reverse complications of disease we know how to prevent. Inefficient clinical research develops clinical scenarios for which one treatment fits all instead of defining populations that will benefit from individualized treatment. Deficiencies in quality of care and clinical research have a common etiology in the inability of physicians to collect detailed clinical data about their patients and to translate medical knowledge to evidence-based clinical decisions. These problems can be solved simultaneously with expert system software that makes computing the central element for collecting clinical data, for translating knowledge to evidence-based clinical decisions, and for collecting population-based, observational databases on the longitudinal behavior of disease to empower robust clinical research programs. CLEOS(r) is a prototype of this approach.