ACAFE (A Computerised Advancement for Emergency) demonstrates the use of an dynamic decision support platform which provides documentation and disease management based on established evidence, guidelines and practice. The decision support platform can easily adapt to other diseases. For evaluation purposes our ACAFE product demonstrates the use of best clinical practice for treatment of one particular chronic disease: Asthma, based on the National Asthma Council Guidelines

ACAFE has been released as an open source project on sourceforge. It is completely free to download and use. For full details on validated trials and studies, installation, setup and support information visit the online forum at http://www.ostechnology.com.au/msdrg-forum/

What is the benefit of using ACAFE?
Incorporating an electronic and automated documentation system together with a built in decision support which incorporates the everyday doctor work flow and integrates features such as management plans, warning alerts and medication suggestions.

Click on the Online Demo to preview a full working version of ACAFE for the clinical/hospital emergency environment.

Released under Open Source License GPL v2. Minimum Requirements: Optimized for IE (Microsoft Internet Explorer) v6+

Project files and source code now available on sourceforge: https://sourceforge.net/projects/acafe/

Screenshots:
1. Introduction login screen:

2. Clinical workspace where users can interact and provide medical data:

3. Decision support tools such as severity grading and alerts

Clinical Goal of ACAFE?
Developing an adaptable, easy to use, interoperable clinical platform for the purpose of bridging together basic clinical practice and evidence based research.

Clinical Workflow Management The clinical platform incorporates multi-environment display panels focusing on emergency environment workflows. Panels are organised according to a pan-out user interface design, that is, the user can
start from the left hand side and follow the logical steps of the clinical pathways from top to bottom or left to right. Hospital management information such as quality time measures, alerts and menu options are clustered into segments based on our usability and interface design analysis.

The distinguishing feature is its adherence to existing paper based design formats and clinical guidelines. For example display of basic patient information such as registration details, triage and essential history notes is contained in the top panel which is also in conformance to standard patient documentation. The main centre panel allows the clinicians to focus on their daily task to input data into the assessment, management, progress note and disposition panels. The layout has ensured minimal user learning.

A unique feature contained in the main centre panel is the reduction of non-essential data fields. The result of our collaborative development approach and user case scenarios enabled us to work on auto-minimizing panels and auto-summary of information field values. This intelligent user interface design allowed clinicians to quickly review the key
emergency patient data and highlight accurately changes to field values.

Real time alerts and data management
The ACAFE clinical platform engages the user in real time to reflect the immediacy of an emergency department workflow environment. Events and treatment orders are updated without need for keying in data and manually “submitting” data at each stage or at each task completion.

Real time updates to patient diagnosis based on
specified values requires little user intervention and data can be managed in real time for disease surveillance and other emergency public health initiatives.

Incorporating emergency diagnosis workflow management the ACAFE system accommodates for real time updates to the suggested management care plan in response to the patient condition. For example, if discovered through the assessment stage that the patient condition is potentially severe, then the suggested management care plan is updated in real time to reflect this need. Clinicians can complete their tasks for patient management.

Real time information gives the clinician significantly more time to extract essential suggested management plans and deal with the important information directly on the main panel without too much user interface clutter.

1. System provides suggested management plan

2. System updates in real time to database

3. Patient documentation complete

Decision Support
The ACAFE system offers the clinicians decision support in several dimensions. Primarily decision support is featured through the administrative care taker function of the system. Following National Asthma Guidelines and standard documentation requirements in the emergency environment, reports such as discharge summaries, discharge requirements, and treatment procedures are all automated.

The ACAFE system also manages the clinical complexity of details by keeping patients on set management plans according to evidence based research, ensuring treatment orders, preventative care and user access to patient details is auditable. For example the ACAFE system ensures users follow the set protocols of patient care and management according to certain assessment field triggers and provides clinicians with suggested management doses of medications.

Cost control is also a key aspect in the ACAFE system where the correct medication orders can be monitored and duplication of input data is avoided throughout the stages of the ACAFE clinical pathways. Adherence to chest x-rays, administration of corticosteroids and other clinical data values are closely monitored to ensure best emergency health care practices.

Built within the ACAFE system is the support for clinical diagnosis and treatment plan processes. The system promotes the use of best practices through the Asthma Severity Grading worksheet which allows the user to conveniently select and review specific data fields. From the Asthma Severity Grading responses condition specific guidelines are then suggested by the system to guide the user along the correct Asthma patient management plan.