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Yearb Med Inform 2006; 15(01): 145-158
DOI: 10.1055/s-0038-1638486
Reviews
Georg Thieme Verlag KG Stuttgart

Computer-Interpretable Clinical Practice Guidelines

Where Are We and where Are We Going?
F. A. Sonnenberg
1   Department of Medicine, UMDNJ Robert Wood Johnson Medical School, New Brunswik, New Jersey, USA
,
C. G. Hagerty
1   Department of Medicine, UMDNJ Robert Wood Johnson Medical School, New Brunswik, New Jersey, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
07 March 2018 (online)

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Summary

Objectives

To provide a comprehensive overview of computerinterpretable guideline (CIG) systems aimed at non-experts. The overview includes the history of efforts to develop CIGs, features of and relationships among current major CIG systems, current status of standards developments pertinent to CIGs and identification of unsolved problems and needs for future research

Methods

Literature re view based on PubMed, AMIA conference proceedings and key references from publications identified. Search terms included practice guidelines, decision support, controlled vocabulary and medical record systems. Papers were reviewed by both authors and summarized narratively.

Results

There is a consensus that guideline delivery systems must be integrated with electronic health records (EHRs) to be most effective. Several evolving CIG formalisms have in common, use of a task network model. There is currently no dominant CIG system. The major challenge in development of interoperable CIGs, is agreement on a standard controlled vocabulary. Such standards are under development, but not widely used, particularly in commercial EHR systems. The Virtual Medical Record (VMR) concept has been proposed as a standard that would serve as an intermediary between guideline vocabulary and that used in EHR implementation.

Conclusion

CIG systems are in a state of evolution. Standards efforts promise to improve interoperability without compromising innovation. The VMR concept can assist guideline development even before clinical systems routinely adhere to standards. Frontiers for future work include using the principles learned by computer implementation of guidelines to improve the guideline development process and evaluation methods that isolate the effects of specific CIG features.

Keywords

Decision Support Systems - Clinical Practice Guidelines / st [Standards] Programming Languages,Software Design - Vocabulary - Controlled - Medical Records Systems - Computerized
 

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