Blackford Middleton

Learn More
We present several techniques for knowledge engineering of large belief networks (BNs) based on the our experiences with a network derived from a large medical knowledge base. The noisyMAX, a generalization of the noisy-OR gate, is used to model causal independence in a BN with multivalued variables. We describe the use of leak probabilities to enforce the(More)
In this paper we assess the value of electronic health care information exchange and interoperability (HIEI) between providers (hospitals and medical group practices) and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers. We have created an HIEI taxonomy and combined published evidence with(More)
There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical(More)
Electronic medical record systems improve the quality of patient care and decrease medical errors, but their financial effects have not been as well documented. The purpose of this study was to estimate the net financial benefit or cost of implementing electronic medical record systems in primary care. We performed a cost-benefit study to analyze the(More)
This document comprises an AMIA Board of Directors approved White Paper that presents a roadmap for national action on clinical decision support. It is published in JAMIA for archival and dissemination purposes. The full text of this material has been previously published on the AMIA Web site (www.amia.org/inside/initiatives/cds). AMIA is the copyright(More)
Value-of-information analyses provide a straightforward means for selecting the best next observation to make, and for determining whether it is better to gather additional information or to act immediately. Determining the next best test to perform, given a state of uncertainty about the world, requires a consideration of the value of making all possible(More)
BACKGROUND Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap. METHODS We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each,(More)
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of(More)
OBJECTIVE Although computerized physician order entry (CPOE) may decrease errors and improve quality, hospital adoption has been slow. The high costs and limited data on financial benefits of CPOE systems are a major barrier to adoption. The authors assessed the costs and financial benefits of the CPOE system at Brigham and Women's Hospital over ten years.(More)
BACKGROUND Web-based personal health records (PHRs) have been advocated as a means to improve type 2 diabetes mellitus (DM) care. However, few Web-based systems are linked directly to the electronic medical record (EMR) used by physicians. METHODS We randomized 11 primary care practices. Intervention practices received access to a DM-specific PHR that(More)