Automatic strategies for decision support in telephone triage

Automatic strategies for decision support in telephone triage by Carlos E. Ferro

The present work started as a research on improvements for an existing Smalltalk application. This application, called ExpertCare, is a decision support tool for telephone triage and ambulance dispatch. ExpertCare analyzes symptoms reported by patients and suggests questions pointing to new symptoms, in order to make a presumptive diagnosis and assess if the call requires an ambulance and/or urgent attention. Besides this primary decision, the system can suggest a special type of ambulance, medical speciality and maximum arrival time. The application has a knowledge base of syndromes defined in terms of symptoms and a system of rules to determine which questions should be asked. But construction and maintenance of such a system of rules is complex and costly, requiring intensive domain expert collaboration; therefore, we aim at developing an automatic strategy which can operate upon the knowledge base and decide which questions are best asked in order to achieve the presumptive diagnosis. Having such an automatic strategy would allow us to get rid of explicit and static rules in favor of an instrument more dynamic and easier to test with full coverage. For that purpose, we needed to build a "virtual laboratory" where we can simulate patient calls and diagnostic sessions in trial runs to check automated diagnosis. In this environment we developed and tested several strategies. We summarize the design of our framework, implementation details of several automatic strategies, and the results of running them in the testbed.

Bio: Carlos E. Ferro has worked as Senior Developer since 2005 in Caesar Systems, a leading company in the field of business simulation. He works there under Leandro Caniglia's leadership. Previously, he was Smalltalk developer in InfOil (information services for petroleoum companies) and Superintendencia de Seguros de la Nación (national insurance oversight board). He was teaching assistant for 8 years at the University of Buenos Aires in several courses of computer sciences -mainly Object Oriented Programming with Professor Máximo Prieto. From 1991 to 2000 he worked on his own as application developer for several small and medium-sized companies. He is currently preparing his graduation thesis in Computer Sciences. Evangelist for Cincom Smalltalk. He’ve given talks at a number of industry conferences, including Smalltalk Solutions, Ot/SPA, LinuxWorld/NetworkWorld, ESUG, and XP/Agile conferences. I'm also the author of the Cincom Smalltalk Blog – “Smalltalk Tidbits, Industry Rants”, and the leader of the "Industry Misinterpretations" weekly podcast. I'm also the author of a few open source tools, such as the RSS/Atom news aggregator BottomFeeder, and of the Silt Blog server.