A cutting-edge medical clinical decision support tool.

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McGraw-Hill Education publishes highly-regarded expert medical reference and education content. Evaluating existing clinical decision support (CDS) tools, McGraw-Hill concluded that all systems have a sufficient volume of content available; the real problem is precision in retrieving an answer.

Existing CDS systems process a user query with minimal analysis/translation, throw it against a database of content, and deliver back multiple large blocks of content where the answer might be. These systems have been built out to more closely resemble traditional searchable medical textbooks (albeit very large ones that are updated frequently) than the “fast answer engines” they were conceived as.

As the content in these blocks expanded without the modification of the search technology, the time needed to find a specific answer increased. McGraw-Hill heard repeatedly from users that searches of these systems generally require a secondary search/browse task where the user has to locate their specific answer in the large content block returned by the search engine. (AKA the “search after the search.”) The products had lost focus on fast answers and had morphed into larger education/reference systems.

To distinguish a new CDS product in the market, McGraw determined that they would need to take an innovative search and retrieval approach—with a key focus on speed to specific answer.

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The ClinicalAccess Difference

ClinicalAccess is built for speed—speed from query to answer with as few off-task distractions as possible. ClinicalAccess achieves this mission by matching user search queries to one of 115,000 pre-created specific clinical questions.

With this approach, the answer provided is much shorter and closely targeted to the specific question. Most answers are a single sentence, paragraph, figure, table, video, or short combination of these elements. When users ask broader questions such as “SLE treatment” they get back broader (multi-section) answers; when they ask more specific questions such as “hydroxychloroquine use for SLE” they get back specific (single paragraph) answers. In ClinicalAccess, the answers match the broadness/specificity of the question down to a very granular level—unlike others that deliver the same full SLE monograph to all SLE queries, regardless of specificity. We’ve eliminated the “search after the search” and greatly reduced the time from search to answer.

Masterful Simplicity

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    Step 1 Enter Query
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    Step 2 Highly-Relevant
    Questions Returned
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    Step 3 Targeted,
    Concise Answers

Product Development Collaboration

Achieving this outcome was a multi-year effort that leveraged the best of McGraw-Hill and Silverchair. McGraw-Hill used their expert author network to create more than 115,000 clinical questions that span all of medical care—ranging from the most common questions to the most complex. Each of the authors selected and reviewed the best, most targeted answer to each question from McGraw-Hill’s 300,000+ page medical content database.

Silverchair used their semantic enrichment technology to generate a detailed semantic classification of each question and developed a custom search that uses a proprietary medicine-specific ontology and thesaurus to analyze highly- variable user phrasing and return the most relevant clinical questions. Silverchair’s designers developed a responsive “speed-first” user experience for desktop, tablet, and mobile that quickly gets users to answers with little distraction.

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User feedback has shown an achievement of our goal. When asked open-endedly to list any differences between ClinicalAccess and existing systems, testers overwhelmingly responded that ClinicalAccess distinguishes itself by being the fastest system for retrieving a specific answer.

However, McGraw-Hill and Silverchair recognize that in modern product development a live launch is a beginning, not an end, and we both maintain teams tasked with the continued improvement of ClinicalAccess in the years to come. McGraw-Hill’s expert authors are using an authoring system built by Silverchair to create and add new questions and answers to the live site on a daily basis. Silverchair semantic experts are analyzing ClinicalAccess searching patterns and adding new jargon, terminology variations, and concept relationship logic on a weekly basis. And we’re both actively gathering feedback from users to factor in to future design and content decisions—all with the ultimate goal of making ClinicalAccess the dominant next-generation answer system at the point of care.

Testers overwhelmingly responded that ClinicalAccess distinguishes itself by being
the fastest system for retrieving a specific answer.

ClinicalAccess at Launch: A Snapshot

  • 115,000+

    targeted clinical questions and answers drawn from 300,000 pages of medical content.

  • 20,000

    images, tables, audio and video clips directly integrated into answers.

  • 1,585

    major topics covered across 27 specialties.

  • 1,800

    drug monographs integrated into search and answer text.

  • 200

    ClinicalAccess-specific authors and editors, in addition to the thousands of editors and authors whose contributions serve as the answers.

  • 12

    user testing sessions over 6 months with hundreds of participants.