An expert system for monitoring psychiatric treatment

A number of medical expert systems have been developed to address problems in health care, but there have been few applications to date for psychiatric practice. We have previously discussed design and implementation issues specific to this medical specialty, and have described OVERSEER, a prototype expert system for monitoring drug treatment in a psychiatric setting. Since its initial implementation, this prototype has been substantially modified based on clinical experience, and in this article we report on the operation and evaluation of the resulting “Clinical Evaluation and Monitoring System” (CEMS). CEMS addresses the essential elements of the clinical process-assessment, diagnosis, and treatment. The Pharmacotheraapy Guidelines contain information about psychiatric medications (e.g., dosages, therapeutic serum levels, indications and side effects), and they reflect the institutions´ “standards of practice”. The Diagnostic Checklists (DCLs) provide an automated method for (1) assuring documentation of the key symptoms and behavioral issues noted in the patient assessment, and (2) noting the degree of change in each symptom/behavior at the time of the discharge (or other) evaluation. The Outcome Assessment module provides data about patients´ functional, social, and vocational status at admission and discharge, and at three, six, and twelve months post-discharge