IOL Clinical Evaluation and Monitoring System (CEMS)
John W. Goethe, M.D. and Bonnie L. Szarek, R.N.
The goal of The Institute of Living Clinical
Evaluation and Monitoring System is to assure the optimal outcome for every
patient.
To meet this goal The Institute has developed an automated decision
support system. The components are: Pharmacotherapy Guidelines,
Information Alerts, Diagnostic Checklists, and the Outcome
Assessment Program.
Pharmacotherapy Guidelines: This on-line document
summarizes key information about the use of selected psychiatric medications
(dosages, therapeutic serum levels, indications and side effects). It also
presents "decision trees" to guide drug selection.
Information Alerts: These computer-generated messages
notify clinicians of events that do not conform to practice guidelines and
medication protocols. Clinicians may respond to these notices by changing the
treatment plan/diagnosis/laboratory orders to comply with "usual
practice" (defined in the Pharmacotherapy Guidelines) or by documenting the
reason for alternative treatment, using a standard form to record the response.
(The response is then automatically entered as a progress note in the patient’s
medical record.)
Diagnostic Checklists (DCLs): The DCLs provide an
automated method for assuring documentation of the key symptoms and behavioral
issues that support the assigned diagnosis and for noting the degree of change
in each symptom/behavior at subsequent evaluations (e.g., at discharge). There
is a separate checklist for each psychiatric diagnosis that reflects DSM
criteria for that diagnosis.
Outcome Assessment Program (OAP): Clinical staff
interview every patient at admission and discharge, using a brief questionnaire
to assess items related to functioning and productivity. The patient is
contacted at one, six, and twelve months post-discharge to assess functional
status and subsequent psychiatric treatment received. Manager: Steve Woolley,
M.P.H., D.Sc. Administrative Assistant: Nancy Lill
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