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Isabel System FAQs

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What Is The Isabel Decision Support System?
Isabel is a Web-based diagnosis decision support system designed to improve the quality of diagnosis decision making at the point of care. Isabel provides an instant check list of diagnoses for the clinician to consider. In a split second and at the point of care, Isabel addresses the question clinicians frequently ask themselves: What are the diagnoses I should be considering?

Isabel is comprised of two components: the Isabel Diagnosis Checklist System (IDCS) and the Knowledge component. Given a patient's clinical features, IDCS searches through the Isabel database of more than 11,000 diagnoses and 4,000 drugs and provides the clinician with a checklist of likely diagnoses and/or drugs that may be causing a patient's symptoms and signs. The Knowledge component provides physicians with diagnosis specific knowledge in their workflow to help answer clinical questions and improve the quality of decision making.
How Does Isabel Work?
At the point of care, a clinician enters a patient's symptoms and clinical signs or this data is extracted from the electronic medical record. Isabel checks the symptoms and signs against its vast database to provide the clinician with a list of likely diagnoses and/or drugs that may be causing the symptoms and signs. Isabel is designed to augment and enhance a clinician's pattern recognition and cognitive skills by providing a reminder checklist of likely diagnoses that should be considered. Isabel acts as an instant reminder system and aids the diagnosis process, however, it is up to the user's clinical judgment to determine which diagnoses to investigate and treat. Diagnosis decision-making will always remain the responsibility of the clinician who is the learned intermediary at the point of care.
Where Does The Content In The Database Come From? How Often Is The System Updated?
Isabel uses proprietary natural language processing software to search a database of widely read medical textbooks and journals for information. The Isabel database is continually updated and the quality of Isabel's results are validated each week, by a designated team of clinicians using a spectrum of clinical cases that include the New England Journal of Medicine Clinical Pathology Conference (CPC) cases. Corroborative knowledge from prestigious medical publishers Lippincott Williams and Oxford University are also included in the Isabel package and displayed to users. User group involvement ensures that the Isabel is continuously enhanced in terms of software and functionality.
What Potential Benefits Does Isabel Offer Hospitals/Physicians/Patients?
The Isabel clinical decision support system has a multitude of benefits for hospitals, patients and physicians. Most importantly, Isabel can significantly help reduce the risk of an important diagnosis being missed or delayed thereby improving the overall quality of patient care. For hospitals and community physicians, Isabel can also be used as a teaching tool to remain up-to-date on new studies, presenting symptoms and diseases.

As a digital knowledge resource, Isabel is unique. Unlike most knowledge resources, Isabel aids the diagnosis process by first analyzing a patient’s symptoms and signs, constructing a list of likely diagnoses and then providing synoptic diagnosis-specific knowledge from textbooks and journals in the workflow.

For physicians, Isabel has been shown to save critical moments, particularly when physicians are presented with complex cases. Isabel provides a structure of where to start looking and reduces the need to cross reference symptoms from multiple sources. While the tangible benefits are plentiful, the greatest potential benefit for physicians is peace of mind that they have done due diligence and considered every option when diagnosing a patient.
Is The Isabel System Solely For Use With Complicated Medical Cases?

No. Isabel was not designed specifically for complicated cases; it is a valuable resource for everyday cases and can be used simply as a refresher for a physician should he/she need it. Isabel enables physicians to feel confident that they have considered all possibilities. Even when presented with a so-called common case there is always a chance it may quickly become complicated if a symptom or sign is overlooked or develops suddenly.

Has Isabel Been Validated?

Yes. A number of independent, multi-center, collaborative studies have proven Isabel's ability to reduce diagnosis error, and improve patient safety and quality of care. In fact, a November 2005 study found that Isabel provided the correct diagnosis 96 percent of the time when key clinical features from 50 challenging Clinical Pathology Conference (CPC) cases reported in the New England Journal of Medicine were entered into the system.

Does Isabel Cause Physicians to Order Unnecessary Tests?

No. Studies have disproved the idea that physicians spend an excessive amount of time "over-thinking" their diagnosis of patients based on the information Isabel offers. Furthermore, a recent study published in BMC Medical Informatics and Decision Making showed that no deleterious tests or treatment steps were added by clinicians following Isabel consultation.

How Does Isabel Assist In Bioterrorism Preparedness?

In the event of a bioterrorist attack, the Isabel system includes an extensive list of bioterrorism diagnoses. This enables physicians, who may lack the necessary clinical training and experience, to distinguish bioterrorism conditions and more easily recognize and diagnose unfamiliar symptoms. Isabel addresses the knowledge gap by suggesting causative bioterrorist agents and providing up-to-date information from the Centers for Disease Control (CDC).

Does Isabel Interface With Electronic Medical Records (EMR)?

Yes. Isabel is the only diagnosis decision support system that interfaces with EMRs. Data from pre-assigned fields within the EMR (age, gender, presenting/chief complaints, etc.) can be submitted to Isabel via a single click on an Isabel button in the EMR. Isabel then returns potential diagnoses. To date, Isabel interfaces with NextGen, PatientKeeper and A4 Health Systems, along with a number of hospital-based EMR vendors including Cerner, Misys, Eclipsys.

Has Isabel Been Recognized for CME Accreditation?

Isabel has been recognized for AMA PRA Category One as a point-of-care learning system. Isabel has the ability to capture each individual user's session details including queries fired, knowledge components used and impact on learning and clinical practice for collation and submission for CME accreditation.

Does The Isabel System Require Formal Training Or Additional Infrastructure?

No. Isabel is a user friendly, Web-based system that requires only an Internet connection.

How Long Does It Take To Begin Using The Isabel System?

Typically, account set-up requires only a few minutes. Following set-up, access to the database and usage begins immediately.

Is Isabel Compatible With A PDA?

Yes. Isabel is formatted for use on PDA with wireless Internet connectivity. This allows physicians to access information at the bedside and across the continuum of care-from the physician's office to the hospital.

How Much Does Isabel Cost?

Hospitals can purchase the Isabel system for less than 50 cents per day, per bed. The annual cost for hospitals starts at $180 per bed and reduces on a sliding scale with size. Individual physicians and group practices can purchase Isabel for approximately $60 per provider, per month. There are no additional set up or upgrade fees.

How Can Physicians/Hospitals Learn More About The Isabel System?

To learn more about the Isabel system, visit and/or call (703) 787-0380