Role of physicians' reactance in e-iatrogenesis: a case study with ASTI guiding mode on the management of hypertension.

Clinical decision support systems (CDSSs) have the potential to increase guideline adherence, but factors of success are not yet understood. ASTI guiding mode (ASTI-GM) is an on-demand guideline-based CDSS where the user navigates in a knowledge base to get the best treatment for a given patient. We conducted a web-based evaluation of ASTI-GM, carried out as a before-after study, where general practitioners (GPs) were asked to solve 5 clinical cases, first without ASTI-GM, then using the system.

Why GPs do not follow computerized guidelines: an attempt of explanation involving usability with ASTI guiding mode.

Clinical decision support systems (CDSSs) have the potential to increase guideline adherence, but factors of success are not well understood. ASTI-GM is an on demand guideline-based CDSS where the user interactively characterizes her patient by browsing the system knowledge base to obtain the recommended treatment. We conducted a web-based evaluation of ASTI-GM as a before-after study to assess whether the system improves general practitioners' (GPs) performance and how they would use it.

Patient data synchronization process in a continuity of care environment.

In a distributed patient record environment, we analyze the processes needed to ensure exchange and access to EHR data. We propose an adapted method and the tools for data synchronization. Our study takes into account the issue of user rights management for data access and decreasing the amount of data exchanged over the network.

Component-based mediation services for the integration of medical applications.

Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health-care information systems. The European project SynEx aims at developing an integration platform for both new and legacy applications on each partner's site. We developed, in this project, mediation services based on the generic and reusable software components that facilitate the construction of an integration platform and ease the communication and the meaningful transformation among distributed and heterogeneous applications.

Integrating medical applications in an open architecture through generic and reusable components.

Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health care information systems. It forces the development of open and modular integration architectures. Major issues in the development include defining a flexible and robust federation model, developing interaction and communication facilities as well as the mechanism insuring semantic interoperability.