Supporting Physicians during Administration of Treatment Protocols
TDSS supports physicians in the daily administration of treatment protocols.
On the basis of the protocol to be followed and actual patient clinical data, TDSS suggests actions to be performed, as timing and amount of drugs to be administered as well as the day of the next visit.
TDSS allows teams of physicians to define portfolios of treatment protocols to use and enables their consistent administration by team members.
Actual fertility treatments currently in use at the Division of Reproductive Endocrinology of University Hospital Zurich have been successfully defined and made available within TDSS.
Treatment protocols defined in TDSS go much beyond usual clinical guidelines. They precisely encode the strategy to follow on the basis on patient data, as external factors (for example, age) and clinical measurements (for example, as for fertility treatments, antral follicle count and hormone blood levels).
TDSS monitors treatments on actual patients and stores physician decisions and deviations with respect to defined protocol, enabling ex-post analyses and discovery of better strategies.
By suggesting clinical actions according to the protocol to be followed, TDSS allows new physicians to be quickly able to properly administering treatment protocols defined within the system, under remote control by supervisors.
TDSS enables fertility centres to foster networking by sharing successful treatment protocols with partner clinics in an intellectual property protecting environment.
Like all software services developed within Paeon, TDSS is not restricted to fertility treatments, as it is ready to be used with other treatment protocols using different drugs and relying on different patient clinical data.
Here we show a short virtual tour of TDSS, giving a glimpse of the user interface and its main features.
In our short virtual tour we show how TDSS can be used by a physician when administering one of the protocols available in the system to an actual patient.
After having created a new treatment administration record for an actual patient, TDSS drives the physician into the initial phase of the protocol.
In particular, TDSS requires the physician to enter patient data needed for the correct protocol administration and not already available within the system, as well as the outcome of the required initial clinical measurements (for the protocol shown in the figure, antral follicle count, AMH blood level and starting cycle day).
As the selected protocol (Long protocol in use at University Hospital Zurich) consists of a Downregulation phase followed by a Stimulation phase, TDSS suggests a proper starting day and duration for the Downregulation phase, as well as the initial dosage for the drug that will be used in the first days of the subsequent Stimulation phase.
These decisions depend on the patient data just entered according to rules precisely defined in the treatment protocol model.
Of course, the physician can override system suggestions and post the reason for the applied changes.
On each patient visit, the physician recalls the state of the patient treatment.
TDSS asks to enter the outcomes of the clinical measurements prescribed on the last visit and, on such a basis, suggests the next clinical actions to be performed until the next visit, namely:
Again, the physician can freely override any system suggestion and add a reason for that. All deviations are tracked by the system.
As a result of the outcome of the clinical measurements just inserted during a patient visit, TDSS may recognise that the success condition is met. In this case, TDSS suggests to end the treatment and to proceed with ovulation induction and eggs retrieval.
Analogously, TDSS may recognise that a safety condition on the patient is violated or that, given the current state of the patient, there is no hope to reach the success condition by continuing the treatment. In this case, TDSS suggests to stop the treatment, also showing the reason behind the failure.
As in all other cases, the physician can override such system suggestions, thus deciding to continue the treatment (also adding a reason for that).
All deviations with respect to system suggestions and all the subsequent clinical actions performed by the physician are tracked by the system to enable ex-post analyses and possible discovery of better strategies.
