Skip to main content

Data Driven Order Set Development Using Metaheuristic Optimization

  • Conference paper
Artificial Intelligence in Medicine (AIME 2015)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 9105))

Included in the following conference series:

Abstract

An unanticipated negative consequence of using healthcare information technology for clinical care is the cognitive workload imposed on users due to poor usability characteristics. This is a widely recognized challenge in the context of computerized provider order entry (CPOE) technology. In this paper, we investigate cognitive workload in the use of order sets, a core feature of CPOE systems that assists clinicians with medical order placement. We propose an automated, data-driven algorithm for developing order sets such that clinicians’ cognitive workload is minimized. Our algorithm incorporates a two-stage optimization model embedded with bisecting K-means clustering and tabu search to optimize the content of order sets, as well as the time intervals where specific order sets are recommended in the CPOE. We evaluate our algorithm using real patient data from a pediatric hospital, and demonstrate that data-driven order sets have the potential to dominate existing, consensus order sets in terms of usability and cognitive workload.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. HIMSS Analytics: Healthcare IT Data, Research, and Analysis, http://www.himssanalytics.org/hc_providers/emr_adoption.asp.

  2. Horsky, J., Kaufman, D.R., Oppenheim, M.L., Patel, V.L.: A framework for analyzing the cognitive complexity of computer-assisted clinical ordering. J. Biomed. Inform. 36(12), 422 (2003)

    Google Scholar 

  3. Schumacher, R.M., Lowry, S.Z.: NIST Guide to the Processes Approach for Improving the Usability of Electronic Health Records (November 2010)

    Google Scholar 

  4. Ash, J.S., Berg, M., Coiera, E.: Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J. Am. Med. Inform. Assoc. 11(2), 104–112 (2004)

    Article  Google Scholar 

  5. Jung, M., Riedmann, D., Hackl, W.O., Hoerbst, A., Jaspers, M.W., Ferret, L., Lawton, K., Ammenwerth, E.: Physicians’ Perceptions on the usefulness of contextual information for prioritizing and presenting alerts in computerized physician order entry systems. BMC Med. Inform. Decis. Mak. 12(1), 111 (2012)

    Article  Google Scholar 

  6. Payne, T.H., Hoey, P.J., Nichol, P., Lovis, C.: Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system. J. Am. Med. Inform. Assoc. 10(4), 322–329 (2003)

    Article  Google Scholar 

  7. Zhang, Y., Padman, R., Levin, J.E.: Paving the COWpath: data-driven design of pediatric order sets. Journal of the American Medical Informatics Association: JAMIA 21(e2), e304–e311 (2014)

    Google Scholar 

  8. Ash, J.S., Sittig, D.F., Poon, E.G., Guappone, K., Campbell, E., Dykstra, R.H.: The extent and importance of unintended consequences related to computerized provider order entry. J. Am. Med. Inform. Assoc. 14(4), 415–423 (2007)

    Article  Google Scholar 

  9. Klann, J., Schadow, G., McCoy, J.M.: A recommendation algorithm for automating corollary order generation. In: AMIA Annu. Symp. Proc., vol. 2009, pp. 333–337 (2009)

    Google Scholar 

  10. Ali, N.A., Mekhjian, H.S., Kuehn, P.L., Bentley, T.D., Kumar, R., Ferketich, A.K., Hoffmann, S.: Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients. Crit. Care Med. 33(1), 110–114 (2005)

    Article  Google Scholar 

  11. Wright, A., Sittig, D.F.: Automated development of order sets and corollary orders by data mining in an ambulatory computerized physician order entry system. In: AMIA Annu. Symp. Proc., pp. 819–823 (2006)

    Google Scholar 

  12. Munasinghe, R.L., Arsene, C., Abraham, T.K., Zidan, M., Siddique, M.: Improving the utilization of admission order sets in a computerized physician order entry system by integrating modular disease specific order subsets in, a general medicine admission order set. J. Am. Med. Inform. Assoc. 18(3), 322–326 (2011)

    Article  Google Scholar 

  13. Hulse, N.C., Del Fiol, G., Bradshaw, R.L., Roemer, L.K., Rocha, R.A.: Towards an on-demand peer feedback system for a clinical knowledge base: a case study with order sets. J. Biomed. Inform. 41(1), 152–164 (2008)

    Article  Google Scholar 

  14. Glover, F.: Tabu search-part I. ORSA Journal on Computing 1(3), 190–206

    Google Scholar 

  15. Glover, F.: Tabu search-part II. ORSA Journal on Computing 2(1), 4–32

    Google Scholar 

  16. Bai, X., Padman, R., Ramsey, J., Spirtes, P.: Tabu Search-Enhanced Graphical Models for Classification in High Dimensions. INFORMS Journal on Computing Summer 20, 423–437 (2008)

    Article  MATH  MathSciNet  Google Scholar 

  17. Michelon, P., Dib Cruz, M., Gascon, V.: Using the tabu search method for the distribution of supplies in a hospital. Annal. Op. Res. 50(1), 427–435 (1994)

    Article  MATH  Google Scholar 

  18. Zhang, Y., Padman, R., Levin, J.E., Mengshoel, O.: Data-driven Order Set Development in the Pediatric Environment: Toward Safer and More Efficient Patient Care. Heinz College Working Paper. Carnegie Mellon University (2015)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yiye Zhang .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this paper

Cite this paper

Zhang, Y., Padman, R. (2015). Data Driven Order Set Development Using Metaheuristic Optimization. In: Holmes, J., Bellazzi, R., Sacchi, L., Peek, N. (eds) Artificial Intelligence in Medicine. AIME 2015. Lecture Notes in Computer Science(), vol 9105. Springer, Cham. https://doi.org/10.1007/978-3-319-19551-3_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19551-3_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19550-6

  • Online ISBN: 978-3-319-19551-3

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics