DSS for Health Emergency Response: A Contextual, User-Centred Approach

1. Introduction

Medical decision-making is influenced by numerous factors that can be classified according to Haynes et al (2002) into: (a) research evidence relevant to a clinical problem or decision; (b) physiological rationale; (c) individual experience. In addition, the context of decision-making severely affects the choice and mix of decision criteria: decisions tend to rely solely on human judgment when the timeframes are short, the situation is stressing, the available information is incomplete, and when there is a lack of recorded evidence about similar past situations. Health emergency response is a perfect example of such a stressing environment: it requires the intense and continuous cooperation and decision-making of various people and roles involved in life-critical situations of providing urgent medical care.

Health emergency response systems have been studied from a number of perspectives. A large stream of research has focused on service optimisation issues (Derekenaris et al., 2001; Yoo et al., 2005; Haghani & Yang, 2007); other systems emphasise on technology related to network and information technology integration (Kyriacou et al., 2003); while other approaches focus on remote medical intervention through telemedicine (Chu & Ganz, 2004). Regardless of the focus of each approach, it is widely admitted that any approach for health emergency response should build upon current norms, practices and knowledge of people and organisations involved. According to Carver and Turoff (2007, p. 38) “a user-centred systemic approach is required with a major emphasis on user requirements driving technological developments (for the design of emergency response systems)”.

The paper presents the design approach and architecture of a Decision Support System (DSS) that supports the real time representation, communication and logging of various types of information about incidents that require urgent medical assistance for the case of the Hellenic Centre for Emergency Health Care (ΕΚΑΒ, http://www.marinetraffic.com) (Lekkas et al., 2008). The DSS delivers useful information at the coordinating centre and the points of care and records incident management data like calls, transportations, hospitals’ treatment, patients’ health problems and response times. This provides the necessary data and network infrastructure for evidence-based decision making. Evidence-based decisions do not rely on human judgement and previous clinical experiences alone, but take into account a wide range of data about the situation at hand including recorded past similar cases.