Execution Of Clinical Guidelines Research Articles

Application of a Conceptual Framework for the Modelling and Execution of Clinical Guidelines as Networks of Concurrent Processes

We present a conceptual framework for modelling clinical guidelines as networks of concurrent processes. This enables the guide- line to be partitioned and distributed at run-time across a knowledge-based telemedicine system, which is distributed by definition but whose exact physical configuration can only be determined after design-time by considering, amongst other factors, the indi- vidual patient's needs. The framework was applied to model a clinical guideline for gestational diabetes mellitus and to derive a prototype that executes the guideline on a smartphone. The framework is shown to support the full development trajectory of a decision support system, including analysis, design and implementation.

Towards automated generation and execution of clinical guidelines: Engine design and implementation through the ICU Modified Schofield use case

As the complexity and amount of medical information keeps increasing, it is difficult to maintain the same quality of care. Therefore, clinical guidelines are used to structure best practices and care, but they also support physicians and nurses in the diagnostic and treatment process. Currently, no standardized format exists to represent these guidelines. Translating guidelines into a computer interpretable format can overcome problems in the physicians' workflow and improve clinician's uptake.An engine is proposed to automatically translate and execute clinical guidelines. These guidelines are represented as flowcharts, expressed in either (i) a computer interpretable guideline format or (ii) a UML diagram. A detailed overview of the architecture is presented and algorithms, aiming at grouping several components and distributing the guidelines, are proposed to optimize the execution of the guidelines.The Modified Schofield guideline for the calculation of the calorie need for burn patients was used for evaluation. Results show that the execution of guidelines using the engine is very efficient. Using optimization algorithms the execution times can be lowered.

Integration of workflow and rule engines for clinical decision support services.

Although recent studies have suggested the feasibility of integrating workflow and rule technology in a Clinical Decision Support System (CDSS), their implementation has not been verified yet. This paper proposes a knowledge engine which integrates workflow and rule engine as a tool for interpretation and execution of computer interpretable clinical guidelines. The objective of this paper is to validate its feasibility in two perspectives: clinical knowledge coverage and execution performance. The two open source engines which were selected and integrated were chosen due to their reliability and consistency. Implementation of workflow and rule engine integration has shown that the integrated knowledge engine (uBrain) is an effective CDSS for the execution of clinical guidelines.