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Friday, September 28, 2007

Visual Patient Drug Interactions Display (when?)

This past week I've been reminded of the complex health and social care problems that an individual person can present. These problems with multiple pathology can mean that 2-3 clinical consultants are involved; a key focus of their input being specific advice on prescribing across neurology, mental health and physical care respectively. In between are families, care home staff, home management, acute, primary, secondary care and the care commissioners all striving to provide the best care possible amid a complex situation.

In such instances of shared care I wondered about what technology can bring to bear in terms of visual tools. Polypharmacology is the permanent front page headline of our Caring Times. Is it possible to present graphically the medication list for an individual and have the latest dynamic clinical and pharmacological data presented and coded in graphical links between the drugs? As drugs are added or excluded, could the efficacy of the drug regimen be measured? Eventually, lab results might also be factored in. Thinking of technical and engineering applications the tools are probably already out there?

I've done a brief search, but have not found anything significant so far beyond this tabular HIV drug interactions tool. There are bound to be many projects and research papers out there. Perhaps the pick-list tabular format is sufficient? The principle of KISS should apply here given the safety concerns. The data to feed such an illustrated beast is loaded not just with facts and (marketing) hyperbole, but major socio-political issues too. Fancy graphics may add complexity, not reduce it?

Such tools are inevitable though. Can you imagine (amid possible cries of heaven forbid!) when the public have access to pharmacological knowledge and the referral battle is one between the medical decision support system as it supervises requests and suggestions from the 'patient' (i.e. the patient's e-health care manager) regards their drugs. Of course, in future as drugs become personalised the demand for this may reduce..?

A standardised way to display drugs information graphically, revealing at a colour-line-sound coded glance the various interactions would be a major step-forward. I can just see the clinical consultants being able to remotely annotate and update the shared drug display with their notes. The patient and/or their family also being privy to the dialogue.

The existing tabular format is text-bound to struggle as bio-genetic data is added to this personal prescription suite. Another search shows that XML, XSL and SVG can all help to make this happen. I hope so and soon.

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