Reference: Aziz A. Boxwala, Samson Tu, Mor Peleg, Qing Zeng,
Omolola Ogunyemi,
Robert A. Greenes, Edward H. Shortliffe, and Vimla L. Patel. Towards
a Representation
Format for Sharable Clinical Guidelines. Journal
of Biomedical Informatics, in press.
Abstract: Clinical guidelines are being developed for the purpose
of reducing medical errors and
unjustified variations in medical practice, and for basing medical
practice on evidence. Encoding
guidelines in a computer- interpretable format and integrating them
with the electronic medical
record can enable delivery of patient-specific recommendations when
and where needed.
Since great effort must be expended in developing high quality guidelines,
and in making them
computer- interpretable, it is highly desirable to be able to share
computer- interpretable
guidelines (CIGs) among institutions. Adoption of a common format for
representing computer-interpretable
guidelines (CIGs) is one approach to sharing. Factors that need to
be considered in
creating a format for sharable CIGs include (1) the scope of guidelines
and their intended
applications; (2) the method of delivery of the recommendations; and
(3) the environment,
consisting of the practice setting and the information system in which
the guidelines will be
applied. Several investigators have proposed solutions that improve
the sharability of CIGs and,
more generally, of medical knowledge. These approaches can be useful
in the development of a
format for sharable CIGs.
Challenges in sharing CIGs also include the need to extend the traditional
framework for
disseminating guidelines to enable them to be integrated into practice.
These extensions include
processes for (1) local adaptation of recommendations encoded in shared
generic guidelines and
(2) integration of guidelines into the institutional information systems.
Notes:
Keywords:
Full Paper: Full paper available in PDF here .