RetroGuide

RetroGuide is a name of a research project in medical informatics (or more precisely clinical informatics) focusing on using workflow technology in healthcare. In 2009, RetroGuide became a component in a larger project/system called HealthFlow
This is an ongoing project. Several past phases could be described. Initial phase was at Intermountain Health Care in Utah, USA and happened during 2004-2007. The main mode was retrospective use. The development continues at Marshfield Clinic (Marshfield Clinic Biomedical Informatics Research Center) during 2008-2010. The prospective version of the RetroGuide system has been developed (called FlowGuide) and the overal system which is using a workflow engine within an EHR system is called HealthFlow.
RetroGuide uses a flowchart paradigm to represent knowledge. Knowledge represented can be a prospective alert logic or retrospective EHR query question.
RetroGuide has been used on several clinical problems
* investigating blood pressure control in diabetics patients
* investigating pregnancy rate in female patients after treatment of Hodgkin lymphoma
* investigating HEDIS quality improvement measures from NCQA
** osteoporosis measure (OMW)
** cholesterol control in cardiovascular patients (CMC)
* investigating alternative glucose protocol logic for blood glucose control in ICU patients
* course of care for diabetes
* course of care for AMI
* course of care for chronic kidney disease
* detecting adverse drug events (respiratory failure after use of narcotics, Naloxone)
Evaluation
RetroGuide graphical approach to model queries has been formally evaluated in a study involving 18 human subjects with limited database expertise. The study compared RetroGuide technology with SQL. Each subject had to solve 14 analytical tasks using both compared technologies. The qualitative comparison of average test scores showed that the study subjects achieved significantly higher scores using the RG technology.
Each subject also filled a follow-up questionnaire which compared both technologies qualitatively. The results of this qualitative study showed that 94% of subjects preferred RG to SQL because RetroGuide was easier to learn, it better supported temporal tasks, and it seemed to be a more logical modeling paradigm. The second part of the follow-up qualitative questionnaire also asked RG-specific questions based on validated constructs from the Unified Theory of Acceptance and Use of Technology. The results of this second part suggested that a fully developed, RetroGuide-like technology would be well accepted by users.

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