Creative Medicines Management

Stacey Diagrams

Ralph Staceys' Agreement and Certainty Matrix has got me thinking.

In clinical medicine what proportion of what we do is both evidence based and agreed upon by the majority of medics. It could be as low as 20%!

Have a look at the reference and pleas feel free to feedback.

http://www.plexusinstitute.org/edgeware/archive/think/main_aides3.html

posted by John Blenkinsopp @ Thursday, October 13, 2005 0 comments

High Complexity Medical Decisions

What elements of medical decision making qualify as "high complexity?" (For more information, see "Tips for medical documentation and coding.")

Two out of three are required (a large number of diagnoses, complex data to be reviewed, and/or high level of risk):

1. A large number of diagnoses or management options, either:

A new problem with additional investigations
Two established problems that are worse or uncontrolled
One established problem that is worse or uncontrolled and two stable problems
Four stable problems

2. A large amount and/or high complexity of data to be reviewed, including five of the following:

Review of lab test reults
Review of the reports of radiology studies
Planning to order new tests
Directly visualizing and interpreting a test (an ECG, for example)
Deciding to obtain old records or additional history from other sources
Summarizing the relevant findings from other sources
Discussing test results with the performing/interpreting physician

3. A high risk of complications, morbidity, or mortality related to either:

The problem
Chronic with severe exacerbation
Acute or chronic which threatens life or limb (severe kidney disease, for example)
Abrupt change in neurologic status
The diagnostic procedure
Cardiovascular imaging with contrast and risk factors
Diagnostic endoscopy with risk factors
The management
IV narcotics
Drug therapy requiring monitoring for toxicity
The decision to make a patient "not for resuscitation" or withdraw care because of poor prognosis
Elective major surgery with risk factors
Emergency major surgery

posted by John Blenkinsopp @ Friday, October 07, 2005 0 comments

Decision Analysis?

Treeage Software Inc. are a company who supply DA software. Here is a link to their website page that explains more about DA.

http://www.treeage.com/learnMore/index.html


CREAMMs application of DA is in the medicines management arena. But more about that later.....

posted by John Blenkinsopp @ Thursday, October 06, 2005 0 comments

Welcome to Creative Medicines Managements' weblog

CREAMM is the brainchild of Professor Stephen Chapman, Professor of Prescribing Studies and Head of the Department of Medicines Management at Keele University. Steve joined the department in 1993.

Steve's research interests include implementing evidence based medicine, prescribing databases and health service prescribing policies. He leads on the Department's service activity. He sits on a number of national and international prescribing committees and has undertaken international consultancy work in Albania, Belgium, Bosnia, Russia, Sweden, Poland, Denmark, USA HMCs, Canada and South Africa.

As CREAMM develops we will share more about its concept.

posted by John Blenkinsopp @ Tuesday, September 27, 2005 0 comments