the United Kingdom-based Isabel Medical Charity,
Isabel.org.uk was designed in response to a
misdiagnosis that almost killed a 3-year old named
girlís parents, Jason and Charlotte Maude, created
the site in 2000 to provide clinical decision support
and information for pediatrics physicians in an effort
to avert improper diagnoses and preventable illnesses.
With the expert guidance of Dr Joseph Britto, a
specialist in intensive pediatric care, the Maudes
hope that Isabel.org will be widely used by hospitals
and medical professionals throughout the world within
the next five years.
Access to the site is free to all registered
members of the healthcare community, and although the
system was initially targeted at United Kingdom-based
health professionals, Isabelís services are
available to physicians the world over via the
the next year, the management team hopes to begin
offering regionally customized online services. The
site formally launched on 17 June 2002.
was it created?
case demonstrated that a simple illness, chicken pox,
can lead to tragic outcomes if not properly treated.
After multiple visits to the hospital to
address a rising temperature and skin discoloration,
Isabel was finally diagnosed with Toxic Shock Syndrome
and Necrotising Fasciitis (a.k.a. flesh-eating bug),
resulting in multiple organ failure and cardiac
spending two months in the hospital, including four
weeks in intensive care, Isabel was able to go home.
Although she has overcome the sickness that
threatened her life, the experience Isabel endured
left her with some ongoing health problems, mainly
plastic surgery-related treatments that could last
into her teen years.
the National Health Serviceís (NHS) direct online
and telephone advisory service helps advise patients
on courses of action to address specific ailments, the
NHS has not extensively used ICTs in its operations.
However, with donations from institutions and
individuals, coupled with support from the medical
community, Isabel has the potential to bridge the
knowledge gap between physicians throughout the world,
while serving as a catalyst for integrating new
technologies in the NHS. Isabelís experience and the development of the Isabel.org
website underscores the importance of providing
professional and immediate support to physicians
making critical decisions that affect future
does it work?
there are some common use segments of the site, the
bulk of Isabel is dedicated to helping healthcare
professionals formulate their diagnoses.
The Isabel differential diagnostic tool (IDDT),
which runs on pattern matching software provided by
Autonomy Corporation, is at the heart of the site.
By using IDDT physicians can input patientsí
symptoms to retrieve a range of 15 diagnoses from
Isabelís extensive library containing over 3,500
that junior-level doctors and non-specialists are
generally the initial contact that a child has with
the medical community, IDDT provides instant access to
a wide range of symptom and treatment guidelines
created by medical experts.
Another crucial component of the site is the
annotated image library, which affords physicians the
opportunity to compare x-rays and clinical pictures
that have been donated from a variety of medical
site also facilitates an ongoing discussion forum that
allows physicians to share ideas and experiences.
is the future of Isabel.org?
the ever-growing demands for service and increased
regulations on physicians (e.g. Work Time Directive,
alternative and supplementary medical resources, such
as Isabel.org, will play an increasingly important
role in the future of healthcare.
As a testament to the success of Isabel, before
it launched publicly the site had over 3,000 users and
the backing of some of the most talented pediatric
specialists in the United Kingdom The management team
hopes to have the pediatric version of Isabel fully
completed in 2004.
The estimated cost of the first phase of the
site is £517,000.
Thus far, the Charity has raised approximately
£400,000, but needs to double that amount to complete
the system for both children and adults.
Depending on funding, the management team hopes
to begin providing medical reference services for
adults sometime in 2004.
In a recent online United Kingdom Telegraph
article, Dr Britto indicated that the ďonline second
opinionĒ source could potentially reduce medical
errors in the National Health Service.
Isabel site, although spawned from an unfortunate
incident, demonstrates the effectiveness of a
grassroots approach to building a world-class digital
system designed to save lives.
With a sound growth model and a highly
committed staff, Isabel promises to become a model for
information age healthcare-related initiatives.
to the Rescue
by linguistic boundaries, tiredness or capacity
constraints, Autonomy Systemsí pattern
recognition infrastructure software has become a
universal tool for determining the digital
characteristics of text. From the United States Department of Defense to Ericsson
and the Royal Mail, Autonomy offers analyses
based on context rather than words.
For Isabel, Autonomyís program allows
physicians to use a combination of symptoms to
help determine a final diagnosis.
mimicking a doctorís intuition, the Autonomy
diagnostic tool ensures that all possibilities
are covered, thereby avoiding potentially
For Isabel, Autonomyís software draws
from the most widely used medical resources,
including Nelsonís Textbook of Pediatrics and
Forfar and Ameilís Textbook of Pediatrics.
For additional information,
for this case study was compiled from the following
SPU New Initiatives Programme
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WSIS Outcome Documents