Evidence based medicine

Case study


Team members:

  • Vojtech Rysanek
  • Ondrej Pulicek

Business Situation

Client needed platform for distributed creation of medical documentation, based on automatic/semi-automatic evaluation of more than 300 forms, which consists of 2,500+ questions and 12,500+ possible answers. Questions and answers are in textual (computer, handwritten) and also graphical form.

There is a lot of data inside and outside of the medical workflow process which creates the need to store and manage them in one central location. Automatically generated reports with corresponding documents must be processed by defined workflows.

All workflow management (i.e. assign of form, read form, submit form, distributed cooperation on report  and final generating of the report) must be done in rich internet application and in one environment.


Front-end is done as Silverlight application which allows central environment for patients, forms, documents and reports management (Assessment-Therapy-Support model).

Back-end part of the solution uses collaboration system – Microsoft SharePoint 2010. A proprietary generic framework is used to handle submitted form data and then join it with external documentation in one place. High efficiency of automatic report generation is ensured by OpenXML implementation with document templates (textual, graphical, styles of the tables, etc.).

Forms can be filled online (PDF form) or offline (hand written form). Handwritten forms are processed by custom automatic scanning solution.

All processes in the system are done by workflow definitions. 


Insurance companies are using reports for managing patient`s progress – they can easily see the current state of the patient through automatically generated ICF codes (Fig 1Fig 1 – Automatically generated ICF Risk-Resource-Profile Code representation). If there are resources to boost or on the other hand barriers to suppress, they can work with patient accordingly – in cooperation with Medical Doctor and Psychologist. Insurance companies also use this process to handle patients who are having chronically-based problems (i.e. back pain) – to reintegrate them back into the working society.

Another highly used scenario is Burnout Assessment – patients who are having psychic problems, also very often connected to work related issues.

Following figure shows automatically generated ICF Risk-Resource-Profile Code representation

Outlined system is described as the only one currently used real IT-supported solution for Evidence-Based Medicine in EU

(Publication Innovationsmanagement in Gesundheitssystemen, ISBN 978-3862160471).