Hi Community,
Since @samuel34’s demo about our new Drools-based CDS Engine a few weeks ago, we’ve been thinking about how to start actually using the engine in a few practical ways that show value.
One simple idea is: to create a simple demo rule that (1) is actually clinically valuable enough to be a good one for the Out-of-the-Box EMR, and (2) serves as an example of how to use the DMN (Decision Model Notation) specification that the Drools CDS Engine needs.
Idea for a Sepsis Warning flag
So I’m thinking: How about a Sepsis Warning flag? Sepsis is such a critical thing to catch, and can be easily missed in busy departments. And while most triage stations don’t collect data like “source of infection” or other fancier sepsis warning signs, virtually all resource-constrained sites DO collect vital signs - so let’s work with that.
The idea is the flags would show up on the Patient Chart, powered by the CDS Engine + Patient Flags module, and look something like this (more design guidance on Flag UI here):
Source Google Sheet: Sepsis Warning: Example Rule for CDS Engine demo with Drools CSV - Google Sheets
- This was easy to write. I just used the Vital Sign metrics from this established Sepsis Calculator on MD Calc. Then I typed those into a format that the CDS Engine can recognize (well, @samuel34 is helping to turn this into the correct format; I just provided the CSV)
- Note I used the word “Sepsis Warning” instead of SIRS. This is because I have found that awareness of SIRS and what it means is not universal outside of N. America, and even inside of High-Income departments, I’ve found that not all clinical staff know what SIRS means. (However, if anyone wants to correct me and say we should use “SIRS” instead of “Sepsis Warning”, I’m open to that!!)
- Then, we could also have a “Severe Sepsis” warning in the event that the Systolic BP is also very low. It would look like this:
What do you think?
So my question to the community is:
- What do you think? Is Sepsis-warning a good flag to start with?
- Are there other simple or critical formulas you’d recommend?