Hoe kunnen wij kritisch zieke kinderen (nog) optimaal(-er) behandelen over 5 jaar?


Het ergste wat een ouder kan overkomen is dat zijn/haar kind kritisch levensbedreigend ziek wordt. De Kinder IC is dan vaak de laatste strohalm. Gelukkig wordt de behandeling steeds beter op de IC, maar daarmee worden ook de uitdagingen steeds groter. Een zeer belangrijke uitdaging daarbij is groeiende complexiteit van zorg die geleverd moet worden aan toenemend complexe patiënten.

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The case for a Generalized Computerized Provider Order Entry system: GenPRES

What is the problem?

To Err is Human. This is how a landmark paper from 2000 starts, recognizing that “the problem is not bad people in health care–it is that good people are working in bad systems that need to be made safer​*​. The consequences of errors can be described by adverse events. Adverse events that are related to medication and or drug/fluid incidents constitute about 20% of all types of adverse events, which makes this the second most common type of adverse event​†​.

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PICURED Pediatric Intensive Care Research Database

At the PICU (Pediatric Intensive Care Unit) of the University Medical Center Utrecht, we have been working the last years to make the data from our PDMS (Patient Data Management System) available for research. This has resulted in a multilayered system with generic possibilities to extract data and transform those data into a convenient flat table format (as described in a previous post).

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Testing an Event Driven Design of a Resuscitation Protocol

In a previous post a described an event driven domain design to run a resuscitation protocol. I also mentioned that running this protocol in practice can have some pitfalls. One of these pitfalls is the use of a defibrillator that is required to apply a cardio conversion by delivering a shock. We have to test that this cannot ever occur.

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Event Driven Design of a Resuscitation app

For some time now I have been thinking of writing an app to help with running a resuscitation protocol. The resuscitation protocol as provided by the Dutch Advanced Pediatric Life Support is rather straight forward. Yet to adhere to this protocol in a stressful situation for a patient with a life threatening condition is a challenge to many physicians or health care providers.

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Medical Decision Support

The first hit you get when looking for the answer how ‘medical decision support’ is defined points to clinical decision support systems. The definition for wich is formulated as (attributed to Robert Hayward of the Centre for Health Evidence ):

Clinical decision support systems link health observations with health knowledge to influence health choices by clinicians for improved health care

The next logical step is to look at the topic of artificial intelligence in medicine.

However, in clinical practice there are more immediate and practical needs to have support for simpel calculation and lookup actions.

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