NR512 Decision Support Systems and Clinical Decision Tools Essay

NR512 Decision Support Systems and Clinical Decision Tools Essay

NR512 Decision Support Systems and Clinical Decision Tools Sample Essay

Introduction

            Big data analysis is an area that is growing prominence in all sectors. It involves the processing of large amounts of data both from within and outside an organization to support decision making. The medical field is among the largest producers of data. As such, it can benefit immensely from big data analytics to enable it to achieve its objective of enhancing patient outcomes. The introduction of intelligent decision support system such as ChatGPT has the potential to enhance the consumption of evidence based decision making. The systems are easily to deploy, easy to use, provide the expected outcome. This paper argues that healthcare institutions should enhance their data consumption by using ChatGPT.

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Selection of Relevant Topic

The healthcare industry is among the world’s leading generators of data, contributing at least 30% of all generated. Informatics, is a field that aims to make this data more useful by enhancing its access and analysis to support a decision support system (DSS). That is, a computer system that analyses a large quantity of data sourced from within or from outside an organization to help decision makers to reach a decision that is believed to be the best decision based on the cost-benefit analysis. By system, it implies that it is a combination of software, hardware, data, and people. In healthcare setup, DSS has the potential to be used for many different applications, including billing, research trial, personnel management, and clinical decision tools (CDTs).

At the highest end of DSS is the IDSS. It is a system designed to emulate human decision making. As such, it can be used as either a substitute or a complement for human decision makers. Nevertheless, the use of DSS and IDSS in medicine is a hot topic. With the introduction of a Generative Pre-trained Transformer (GPT) developed by OpenAI called the ChatGPT and its wide application is different areas including the legal system, stakeholders in the healthcare field are wondering if ChatGPT or its equivalent would soon be making diagnostic and other key decisions in healthcare facilities. This paper argues that, the adoption of IDSS could enhance the productivity of human staff in all areas of healthcare, from aiding in research to the clinical setup to make diagnostic decisions.

ChatGPT in Healthcare

ChatGPT is considered among the most intelligent systems to have been developed. It has shown immense capabilities in solving complex problems such as generating programming codes and solve mathematical problems that would otherwise take humans days or even months to solve. A recent study found that the software was capable of almost passing the threshold set for the United States Medical Licensing Exam (USMLE) without undergoing any special training. It demonstrated both concordance and insight in its responses to the medical questions. The USMLE is a difficult examination that requires between 300 and 400 hours of preparation. As such, it can argued that the system can be trained to perform at the level of a human doctor. However, is it okay to use it to make diagnosis for patients just yet?

Pros of Using ChatGPT in Medical Decision Making

According to Kitamura (2023), the software has close to human-level communication capabilities. The system is built on a transformer architecture that had a huge amount of data. The architecture allows ChatGPT to not only provide information in a basic form but to select the best vocabularies to use for its communication. As such, unlike rival AI platforms, its responses are less ambiguous, making it usable even in a field like healthcare. The system can also be used to design chatbots to provide assistance to both healthcare staff and patients. Humans were more likely to stop chatting when they realized that they were chatting with a robot concerning high risk issues (Nov et al., 2023). However, GPT has natural language processing (NLP) that allows it to simulate human conversations, thus achieving higher effectiveness in engaging humans in communicating. As such, its adoption would make chatbots more useful in dealing with the shortage of human user support. Nov et al (2023) however objects, stating that patients need to have the ability to distinguish when they are talking to a human from when they are conversing with a software.

The system is also capable of deep analysis of data. Traditionally, research is considered an important part of a profession in healthcare. Professionals search information from databases and the internet to obtain insights. Normal EHR, are linked to different databases for different purposes. However, ChatGPT is designed to make sense of unstructured data. As such, all the data of the organization can be kept in a single database and analyzed using the software. The expected outcome should be of greater quality than analysis from normal EHR systems. GPT’s application in research however goes beyond providing insights. According to Biswas (2023), the system can be used to write an entire healthcare article with minimal human intervention. As such, it can act as a co-participant in healthcare researches.

Some negative outcomes also originate from ignorance. That is, not knowing the best approach to deal with a problem, or simply inability to know the problem. The problem of ignorance may originate from the human inability to scan through a vast amount of information in databases. ChatGPT, on the contrary, has access to a huge amount of recent data. As such, the software can access even the latest procedures developed in other parts of the world. Its decisions are thus expected to be more accurate than those of human doctors. In a study by Rao et al. (2023), ChatGPT was able to achieve a score of 1.83 out of 2 when its responses were compared to the American College of Radiology (ACR) Appropriateness Criteria for breast pain and breast cancer screening. The outcome was above the human average. Therefore, authors concluded that the adoption of the technology could enhance patient outcome.

Thirdly, it does not tire. Fatigue is a serious issue in the healthcare field. Medical professionals work longer hours due to shortage of workforce. The longer they work, the poorer their decisions are likely to be, leading to higher likelihood of errors. However, a software does not tire. Its accuracy remains relatively constant despite the number of hours served.

The system can also serve healthcare professionals as a virtual assistant. Instead of being the decision makers, they can assist decision makers to answer commonly asked questions, automate patient billing, and to keep and remind staff of their schedules among other applications. That would be possible by embedding the system into the electronics health records (EHR).

Cons of ChatGPT

ChatGPT does not produce accurate responses all the time. Despite its proven usefulness, the system occasionally gives wrong responses, either because the human did not provide it with a query that is clear enough or it did not come up with the right response (Shen et al., 2023). Nevertheless, a wrong response in healthcare can have devastating consequences including loss of life. According to Kitamura (2023), the challenge can be significantly overcome through pre-training. The user can train GPT to fine-tune its responses to their needs. There is also need for an experienced user to issue the software with correct instructions and aid its learning.

Chat GPT is not flexible in its communication approach. It is often too formal in its responses. As such, it may not sound as human as possible. Humans usually adjust their language to their audiences based on different parameters such as the perceived level of education, age, and the purpose of the communication. They may include comedy and sarcasm to make their information more palatable. Being too formal is not always the best way to communicate. A study by Gordijn and Have (2023) also found that the software can be overly sensitive to differences in words that ordinarily would be used interchangeably.

Use of Informatics Skills and Knowledge in Developing the Assignment

Problem solving is among the key skills in informatics. It is not enough to have a large amount of data such as information from the internet and healthcare databases. One must also demonstrate the ability to analyze the information to create solutions to a particular healthcare problem. In this assignment, the problem is the use of AI to make decisions or to assist healthcare professionals to make clinical and non-clinical decisions. From the articles obtained, I was able to dissect to determine what is relevant, summarize information from different sources, compile it into one document and communicate it to my audience. As such, I demonstrated problem solving skills.

Ability to forecast. In most cases, data in databases may only provide information about the past and occasionally about the present. Nevertheless, the usefulness of the data is always in the future. Healthcare analytics aims to uncover trends in data that can be used to predict the future. This process is also knows as forecasting. In this assignment, I managed to find information about the capabilities of DSS systems and IDSS such as the ChatGPT. By observing the trend, one can predict that the capabilities of the systems are only increasing by the day, and in a few years, the systems would be able to rival humans in many fields including in healthcare sciences.

Conclusion

There is compelling reason to support the expansion of use of IDSS systems such as ChatGPT in the clinical setup. The analysis has found that the systems have many strengths, including the ability to generate insights that would otherwise be overlooked by humans. It does so by analyzing a large amount of information in a shorter time that a human could. It can even analyze data from unorganized data to create logical responses. Its communication capabilities, on the other hand, allows it to communicate its findings better than traditional DSS systems. With some training, ChatGPT could assist medical professionals to improve patient outcomes in two ways. First, to overcome the challenge of shortage of personnel and secondly, to overcome human limitations such as the ability to focus over a long time.

References

Biswas, S. (2023). ChatGPT and the Future of Medical Writing. Radiology, 223312.

Gordijn, B., & Have, H. T. (2023). ChatGPT: evolution or revolution?. Medicine, Health Care and Philosophy, 1-2.

Kitamura, F. C. (2023). Chatgpt is shaping the future of medical writing but still requires human judgment. Radiology. https://doi.org/10.1148/radiol.230171

Nov, O., Singh, N., & Mann, D. M. (2023). Putting chatgpt’s medical advice to the (turing) test. https://doi.org/10.1101/2023.01.23.23284735

Rao, A. S., Kim, J., Kamineni, M., Pang, M., Lie, W., & Succi, M. (2023). Evaluating ChatGPT as an Adjunct for Radiologic Decision-Making. medRxiv, 2023-02.

Shen, Y., Heacock, L., Elias, J., Hentel, K. D., Reig, B., Shih, G., & Moy, L. (2023). CHATGPT and other large language models are double-edged swords. Radiology. https://doi.org/10.1148/radiol.230163

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NR512

Health IT Topic of Week Assignment

Guidelines with Scoring Rubric

Purpose

This assignment is designed to help students

• Develop an appreciation for informatics, basic skills and knowledge required in practice settings. Students will select a “hot” or popular topic of particular interest to their practice to discuss. The topic will be selected from the website using the link provided in the course Assignments section.

Due Date: Sunday 11:59 p.m. MT at the end of Week 5.

Total Points Possible:  175

Requirements

Students will login to FierceEMR and FierceHealthIT using the link provided in the reading assignment module for Week 5 and select a  “current/popular” topic of the week that may impact their practice. Students, in a professionally developed paper, will discuss the rationale for choosing the topic, how it will impact practice in a positive or negative manner, citing pros and cons. Include a discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment. In the conclusion, provide recommendations for the future. Submit completed FierceHealthIT   Topic paper for Wk. 5 to dropbox by end of Week 5.

Preparing the paper

1. The FierceEMR and FierceHealthIT Current/Popular Topic of the Week assignment must be a professional, scholarly prepared paper. See the guidelines for writing a professional, scholarly paper in the Course Resources. The professional paper will have an introduction, body of paper to explain what you are doing, summary/conclusion, and at least three scholarly references.
2. Required texts may be used as references, but a minimum of three sources must be from outside of course readings.
3. All aspects of the paper must be in APA format as expressed in the current edition.
4. The paper (excluding the title page, introduction and reference page) is 4-6 pages in length.
5. Ideas and information from professional sources must be cited correctly.
6. Grammar, spelling, punctuation, and citations are consistent with formal academic writing.

Category	Points	%	Description
Introduction	20	11.4	Introduction presents a brief overview of the parts of the paper.
Selects relevant HealthIT Topic to discuss; provides rationale for selecting topic	30	17	Provides convincing rationale for topic selection
Convincing arguments of how topic will impact practice in a positive or negative manner citing pros and cons.	40	23	Convincing arguments of how topic impacts practice in a positive or negative manner; pros and cons are presented
Discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment	30	17	Provides a discussion of how informatics skills and knowledge were used in the process to develop the assignment
Conclusion	20	11.4	Concluding statements summarize insights about the key elements of the paper gained during the assignment. Recommendations for the future are provided
APA Style	20	11.4	Text, title page, body of paper, summary and reference page(s) are completely consistent with APA format.
Citations	7	4	Ideas and information from sources are cited correctly. There are a minimum of three scholarly, current (5 years or less) references.
Writing Mechanics	8	4.5	Rules of grammar, spelling, word usage, and punctuation are consistent with formal written work,
Total	175	100%	A quality assignment will meet or exceed all of the above requirements.

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Grading Rubric

Assignment Criteria	Exceptional Outstanding or highest level of performance	Exceeds Very good or high level of performance	Meets Competent or satisfactory level of performance	Needs Improvement Poor or failing level of performance	Developing Unsatisfactory level of performance
Content Possible Points =  140 Points
Introduction	20 Points	18 Points	16 Points	14 Points	0 Points
	Introduction presents a brief overview all parts of the paper.	Introduction presents one of the two required elements.	Introduction does not include either of the two required elements.	Minimal attempt at introduction.	No introduction is present.
Selects relevant HealthIT Topic to discuss; provides rationale for selecting topic	30 Points	26 Points	24 Points	21 Points	0 Points
	Successfully selects relevant HealthIT Topic to discuss; provides rationale for selecting topic	Selects relevant HealthIT Topic to discuss; provides minimal rationale for selecting topic	Selects  HealthIT Topic to discuss; not related to practice; provides minimal rationale for selecting topic	Selects  HealthIT Topic to discuss; not related to practice; provides no rationale for selecting topic	Does not complete assignment
Convincing arguments of how topic will impact practice in a positive or negative manner citing pros and cons.	40 Points	36 Points	32 Points		0 Points
	Provides convincing arguments of how topic will impact practice in a positive or negative manner -pros and cons  presented.	Some arguments of how topic will impact practice in a positive or negative manner -pros and cons  presented, but are not convincing in nature.	Minimal arguments of how topic will impact practice in a positive or negative manner -pros and cons presented.		No discussion of positive or negative impact presented
	30 points	26 points	24 points		0 Points
Discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment	Discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment is presented	Some discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment.	Minimal discussion of how informatics skills and knowledge were used  presented		No discussion of how informatics skills and knowledge were used
Conclusion	20 Points	18 Points	16 Points	14 Points	0 Points
	Concluding statements summarize insights about the key elements of the paper gained during the assignment. Recommendations for the future are provided	Provides a summary of key points and a partial summary of insights gained during the assignment. Includes some recommendations for future related to topic.	Concluding statements are present but do not address insights and/or includes minimal recommendations for future related to topic	Minimal concluding statements present but no insight or recommendations for future are presented.	No conclusion.
Content Subtotal_____/140 Points									Minimal concluding statement.
Format Possible Points =  35 Points
APA Style	20 Points	18 Points	16 Points	14 Points	0 Points
	0–1 APA format errors in text, title, body of paper, summary and reference page(s) are completely consistent with APA format.	2-3 APA format errors in text, title page, body of paper, summary and reference page(s) are completely consistent with APA format.	4-6 APA format errors in text, title page, in text, title page, body of paper, summary and reference page(s) are completely consistent with APA format.	7-9 APA format errors in text, title page, in text, title page, body of paper, summary and reference page(s) are completely consistent with APA format	10 or more APA format errors in text, title page, in text, title page, body of paper, summary and reference page(s) are completely consistent with APA format.
Citations	8 Points	7 Points	6 Points	4 Points	0 Points
	0–1 errors in identifying ideas, and information from other sources are cited correctly. There are a minimum of three scholarly, current (5 years or less) references.	2-3 errors in identifying ideas, and information from other sources are cited.	4-6 errors in identifying ideas, and information from other sources are cited.	7-9 errors in identifying ideas, and information from other sources are cited.	10 or more errors in identifying ideas, and information from other sources are cited.
Writing Mechanics	7 Points	6 Points	5 Points	3 Points	0 Points
	0–3 errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing	4–5 errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing	6-7 errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing	8-9 errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing	10 or more errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing.
Format Subtotal_____/35 Points									8–9 errors in grammar, spelling, word usage, punctuation, and other elements of formal academic writing
Total Points____/175 Points