Integrated OutcomesTM

... more than a technology.




Why Integrated OutcomesTM?

"Outcomes measurement" was popularized during the tenure of C. Everett Koop in the office of US Surgeon General. The idea is simple: to influence medical decisions of the present and future with the actual results of medical interventions made previously.

The task may not be as simple as the tenant. Although immediate results of medical interventions in hospitals, clinics, offices and rehabilitation centers are easily captured and documented in traditional medical records, capturing and documenting the result of medical intervention is a different story for events that occur outside such settings. It is difficult, if not impossible, to find any data that is systematically captured on the outcomes of outpatients that is suitable for widespread use in medical decision support, with the single exception of the obituaries.

Reasons for this include the cost of soliciting outpatient information, the reply rates associated with requests for such information, and the manageability of responses given the restricted ability of the patient to articulate useful and reliable medical information.

Integrated OutcomesTM collects information from the patient in a systematic way that maintains the reliability and usefulness of timely information on the results of medical intervention in outpatient care. Integrated OutcomesTM extends the capacity of health care services to measure outcomes with a minimum investment by both patient and care giver.


Integrated OutcomesTM is a method for managing results.

Acquisition of information on the results of outpatient medical intervention need no longer be expensive, tedious and undisciplined. Outpatient health care can now be followed with a systematic routine that solicits intervention outcome with a rigor that is friendly, effective, non-taxing and manageable. Structured queries, well-timed, collect information methodically. Questions are easy to understand and beg no more than an instant of patient time to answer. Replies are automatically entered in the medical record. Health care providers are prompted with recommended responses according to practice-chosen policies. The result: unprecedented information, with more consistency and earlier notice, yet highly organized and cost minimized.


Integrated OutcomesTM is based on a technology.

This technology consists of a two-part software system. One part performs the reasoning while the other part houses the rules of operation. This separation preserves the freedom of the health care providers to control the rules of operation. These rules embody the protocols adopted by the practice for two fundamental areas: The articulation of questions to ask the outpatient and the recommendation of responses to prompt the health care provider in the advent of given specific outcomes reported by the patient in reply to those questions.


The part of the system that performs the reasoning (i.e., applies the rules) connects to communication technologies to send the queries to the patient at the right time by e-mail, automated telecommunication or post-card. The same part of the system transforms replies into medical record entries and staff task-list recommendations.



Integrated OutcomesTM is a product and a service.

The patent-pending software system may be licensed for use in any practice. Both the software system and a starting knowledge base are necessary to capture outcomes. The initial knowledge base is customized for the practice based on preliminary interviews of the appointed health care provider and articulated in the form required by the software system.


To be effective, the technology must have an effective body of rules or "Knowledge Base". The acquisition of this knowledge base comes as a result of a partnership between the health care provider and the knowledge engineer. The care provider supplies the fundamental rules and concepts. The knowledge engineer enables the expression of those  rules and concepts in the correct form to be used by the technology and achieve the desired effect. Since the desired effect may not be the same for every practice, the evaluation of effectiveness may demand periodic review, refinement and/or adjustment. Evaluation of effectiveness often begs a depth of insight and prescription for which the health care provider will desire the help of the knowledge engineer as well.


To fulfill the needs of health care providers who employ Integrated OutcomesTM to capture intervention outcomes effectively, our staff provides multiple of levels of assistance:

- Regional Seminars

- Provider Staff Training

- Medical Knowledge Base Construction and Tuning Services

- Medical Knowledge Base Consulting


Medical Knowledge Engineering
& Affiliates


Principal: Duane Steward, DVM, MSIE, Ph.D

10521 Via Del Sol

Orlando, Fl    32817

Phone: 407 960-0900