Dean F. Sittig, Ph.D.

I work for Northwest Permanente, the physicians' group associated with Kaiser Permanente in Portland, OR.  I am the Director of Applied Research in Medical Informatics.  I also serve as the Director of the Clinical Informatics Research Network (CIRN) for Kaiser Permanente at the national level. In this position I am responsible for helping to establish and carry out an applied clinical informatics research agenda for Kaiser.  For more information on this work you can read our paper from The Permanente Journal (Part I - A Clinical Information System Research Landscape ; Part II - A Clinical Information System Research Agenda for Kaiser Permanente) . I am also a faculty member at the Oregon Health and Sciences University in the Department of Medical Informatics and Outcomes Research . From June 1999 until January 2001, I worked for Healtheon/WebMD as a research scientist.  While there I worked mainly on the search feature of the consumer website.  I am most proud of helping to create the medical spell check feature within the search function on the site ( see for example ). From February 1996 until June 1999, I worked in the clinical systems research and development group within the information systems department at Partners HealthCare System in Boston, MA.  Partners was formed in 1994 by the Brigham & Women's Hospital and the Massachusett's General Hospital. In addition to these two large academic medical centers, Partners also consists of over 100 primary care practices and 6 community hospitals in the Boston area. In addition, I was a faculty member in the Department of Medicine at the Harvard University School of Medicine.  I am most proud of my work to design and develop the Clinical Application Suite and a user interaction model , a forerunner of the Clinical Context Object Workgroups' CCOW standard. I also worked on a project to evaluate the clinical referral process and the development of a clinical referral application . Our emphasis within the R&D group was on the creation of clinical systems that help clinicians in their daily work. We were constantly striving to develop new systems that help improve the quality of medical care and/or reduce its cost.

My research interests center around the design, development, implementation, and evaluation of computer-based clinical information systems. Over the last 10 years I have worked on a variety of medical informatics projects including:

1. a computerized patient advice system to manage the hypoxemia of severe adult respiratory distress syndrome patients. This project involved the development of an unprecedented set of highly detailed (over 40 pages) clinical care algorithms which recommended ventilator adjustments for five different modes of ventilation: assist/control, intermittent mandatory ventilation, continuous positive airway pressure, pressure controlled inverse ratio ventilation and Extracorporeal CO₂ Removal (ECO₂R). These algorithms were implemented using the blackboard control architecture within the HELP clinical information system.
2. an evaluation of the effect of a new computer-based charting system on the work patterns of nurses;
3. design and development of an intelligent cardiovascular monitor (ICM). Briefly, the ICM was built using the parallel process trellis, a uniform hierarchical software framework for building heterogeneous real-time heuristic monitoring programs. As a part of this externally funded research project I studied the utility of a parallel version of the Kalman filter to recognize trends and abrupt changes in physiologic signals such as the blood pressure, as well as, to identify specific rhythmic abnormalities in the electrocardiogram. I also lead the development of BIO-SPEAD - a program that facilitated the development of biological signal processing algorithms. Using this framework, we developed an innovative dicrotic notch detection algorithm.
4. developed and evaluated a parallel neural network training algorithm to detect alarm conditions in an anesthesia breathing circuit;
5. developed and evaluated use of fuzzy logic to detect trends and artifacts in the heart rate;
6. developed and evaluated several computer-based educational programs to help clinicians learn to utilize computer workstations within a complex networked environment;
7. developed several new techniques for the evaluation of the journals of a specific field, for an entire library’s journal collection, and to assess the educational needs of library users;
8. developed a plan for the implementation of a state-of-the-art clinical information management system for the King Faisal Specialist Hospital & Research Centre in Riyadh, Kingdom of Saudi Arabia.

Current research projects include:

1. the design, development, implementation and evaluation of a new Clinical Application Suite to be used by clinicians across the Partners’ network. This work is exploring innovative graphical user-interface and interaction concepts in an attempt to improve the quality of patient care by reducing the time and effort required for clinicians to complete their work.
2. assessing the current out-patient referral system within the Brigham & Women’s PHO, and
3. developing a new computer-based clinical referral system for use by primary care and specialty clinicians.
   
   Bibliography

Ó 1998-2001 The Informatics Review