A Salt Lake company is combining medical information developed by a team of Utah doctors with stunning new computer technology. The result: a product that has the potential of helping thousands of patients worldwide.
The company is Applied Medical Informatics, 2681 Parleys Way, and the product is Medical HouseCall, a computer program available on either CD ROM or floppy disks.According to Elaine M. Bailey, president and CEO of Applied, the company was founded in 1986 as a research organization that worked in a relationship with the Medical Informatics Department at the University of Utah.
Much of the information used in the system is a spin-off from a program compiled by doctors working with Dr. Homer R. Warner Sr., chairman of the U.'s Department of Medical Informatics, a pioneer in the medical use of computers. Also involved was his son, Dr. Homer Warner Jr., Bailey said.
The two started a project called Iliad, along with about 25 other physicians at the University of Utah. These doctors, plus about a dozen pharmacists, nutritionists and nurses, contributed information about medicine to build up a huge knowledge base.
Iliad took seven years to develop. Updated annually, this information base is used by about 30 or 40 medical schools around the country to teach medical students. It has been used at the University of Utah School of Medicine for the past four years.
Some of this knowledge base has been incorporated into the remarkable HouseCall computer system.
"It uses just the parts that relate to symptoms and some descriptions of diseases, and then some general knowledge about the disease itself," Homer Warner Sr. told the Deseret News.
Medical HouseCall also has information "about some of the treatments to help inform the patients, so that they go in (to the physician) with a little bit better understanding of the problem," he said.
Warner said the designers of the computer program also "added other things that I think will be useful to patients."
HouseCall was developed using some of the information base in the larger Iliad, under agreements with the university. The U. retains rights to the portion of the system its experts created, and HouseCall has rights to what it developed itself, Bailey said.
Bailey joined Applied about a year ago, helping it make a transition from a research effort to a company that supplies consumer products.
"What we learned in trying to create this product is there's a reason that doctors and patients don't communicate very well," she said.
"They have difficulty talking to one another. They use different languages."
Medical HouseCall attempts to bridge that gap. One way it does this is through a 5,000-page medical encyclopedia, rewritten "so it was patient-friendly and in patient language," she said.
The encyclopedia includes diseases, symptoms, tests, different surgeries, drugs, poisons, injuries, nutrition and illustrations.
"In the disease (section) we have 1,256 diseases," she said. The data bank includes information on 3,746 drugs, both prescription and over-the-counter. It can check 300,000 drug interactions and 6,000 symptoms.
Wondering about surgery? It has data on 65 operations and their costs. The same is true for 515 medical tests. The product also covers 200 other topics.
"We interviewed 26 local doctors, and we asked what makes a good patient, because we were trying to make a patient-oriented product that works with the doctor," Bailey said.
Doctors agreed that a good patient is one who shows up on time and pays bills, describes symptoms and complies with treatment directed by the physician.
"What we tried to do was provide a patient with a way to do those things. We couldn't get them there on time, but we could help them prepare for their appointment by analyzing their symptoms and printing them."
By "printing them," she was referring to the print-out function of the computer program. It gets one's printer to produce a patient profile that can be taken to a doctor.
In developing the program, Bailey met three times with C. Everett Koop, the former surgeon general. He described studies of people with critical illnesses in which the physician had the responsibility to explain the ramifications of the disease and the options available.
"He told me over 90 percent of the time, the patient chose the least-expensive and least-intrusive treatment," she said. Patients were pleased because they were helping to plan their own treatment.
What that means is that patients who know more about the situation - who are able to make a better-informed decision - are better equipped to manage their care. Bailey and her associates at Applied Medical Informatics think their program will help patients do that by helping them understand their conditions.
Bailey emphasized that the HouseCall program is not intended to diagnose patients.
"It can't," she said.
A diagnosis must be made by a physician, who can consider a range of factors beyond what the patient knows - things like results of medical tests, or research into obscure medical journals or general appearance. A patient may not be able to tell the difference between subjective feelings and the physical reality of a condition.
Instead, HouseCall is a computerized system that helps patients understand their situation.
"What it can do is give you a list of possible causes, based on the information you gave it," Bailey said. It can list possible causes of a condition, along with percentages that indicate the likelihood of each.
"An informed patient is someone who can explain what they've got, who knows why they're doing something and can ask good questions." Bailey believes Medical HouseCall helps create informed patients.