Interviewing expertise in primary care medicine: a knowledge-based support system

A patient interview support application (PISA) has been developed to embody interview expertise for primary care medicine. From a patient´s natural language statement of problems and symptoms, the PISA infers which physical systems (e.g. cardiac) are to be investigated in detail. The PISA is an expert information-gathering tool; the physician retains responsibility for interpreting this information. The PISA allows an intelligent questioning session to be conducted by an individual with minimal medical expertise. The PISA encourages a thoroughness of data collection that experts may forego under time pressures, and the printed medical record provides support for the physician´s subsequent treatment decision. A Spanish PISA has been developed to allow interviewing in a language in which the physician is not fluent. Field experiences show the medical information gathered to be both relevant and sufficient to support a diagnosis. The partitioned structure of the PISA is amenable to refinement and customization.<>