No abstract

No abstract

Medicine as knowledge-intensive domain has been the subject of various approaches of computer-based knowledge management. Most of them concentrated on the design and implementation of expert systems for clinical decision support. Today, medical knowledge bases are implemented for various purposes, including encyclopedic sources of information for clinicians. We present a prototypical development of architecture for an electronic patient record which structurally depends on such an encyclopedic representation and is therefore knowledge-based. Using the KADS approach for knowledge engineering, three modeling steps and architectural parts could be identified, definition of basic concepts, the structural knowledge base model, and the interactive process of knowledge instantiation which constitutes clinical documentation. Furthermore, we present an analysis of possible benefits of a knowledge-based electronic patient record in health care as well as in adjacent fields.

Fall prevention is one of the focal points of injury prevention in Switzerland. The incidence rates of fall related injuries (3 500 per 100 000) and deaths (20 per 100 000) are high in global comparison. The main reason is the aging population. Today, people aged 65 and more represent 18% of the Swiss population and their risk to suffer severe injuries from a fall is particularly high. To reduce the burden of injury in the elderly, the Swiss Council for Accident Prevention (bfu) developed a national strategy to prevent falls in the elderly. The bfu has a legal mandate to prevent non-occupational accidents and to coordinate prevention measures in Switzerland.The development of the strategy is based on accident research and uses an effect-oriented prevention cycle for the implementation of the prevention goals. Throughout the prevention cycle, the incidence and severity of injuries are assessed, risk factors and possible prevention measures are identified and rated, prevention goals are set, prevention programs are developed and implemented in close collaboration with stakeholders, and the success of the measures and processes are continuously monitored.The core prevention measures of the fall prevention strategy are exercise and modification of private and public infrastructure. Its implementation involve training of multipliers, advice of local authorities and other stakeholders, and the communication through mass campaigns and other media. To evaluate the fall prevention strategy, we regularly revise its scientific basis and measure its success, as for example through an annual population survey.The national strategy presented here with its research-based and effect-oriented prevention cycle provides a good systematic approach for reducing injuries. It supports the identification of effective, efficient and practical prevention measures. Key to the strategy’s success is the close collaboration with stakeholders in the development and implementation of prevention measures.

No abstract