Development of a Knowledge-Based Clinical Decision Support System for Community Medicine using PDA

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This research aims at developing a mobile, knowledge-based clinical decision support system for community medicine and evaluating the usefulness of the developed system on-site. The system has a client-server architecture and consists of the following components.1.server system : (a)A knowledge generation subsystem that generates diagnostic knowledge from medical data stored on the hospital information systems. (b)An inference system that infers possible candidates of diagnosis based on the generated knowledge. (c)A server application that receives queries from client systems and returns inference results.2.client system : A client application that provides an interface for inputting patient's symptoms and displaying the inference results.In 2004, we have equipped server systems for software development on Shimane University, and implemented the previously developed knowledge generation system and inference systems thereon. We then developed a server application that communicates with client systems, and performed communication experiments with a note PC and a PDA.In 2005, we have implemented the client systems on 2 note PCs and 8 PDAs. After that, we performed an on-site communication experiment in a hospital who is a member of the Shimane network for community medicine.Consequently, we have confirmed that the system can be used with note PCs under the support areas of personal handyphone system services. However, we've also faced the following problems. (1)Current software development environments for PDA are suitable for building the user interface, however, are not sufficient for building intelligent client systems. Therefore, we have to use a Web interface on PDA. (2)In some underpopulated regions, PHS services were not available. Therefore, we had to use other communication devices. These results suggested the limitation of the use of PDA-based mobile telemedicine systems in current regional communication environments.