Guideline execution engine

Last updated

A guideline execution engine is a computer program which can interpret a clinical guideline represented in a computerized format and perform actions towards the user of an electronic medical record.

Contents

A guideline execution engine needs to communicate with a host clinical information system. Virtual Medical Record (vMR) is one possible interface which can be used.

The engine's main function is to manage instances of executed guidelines of individual patients.

Architecture

The following modules are generally needed for any engine:

Guideline Interchange Format

The Guideline Interchange Format (GLIF) is a computer representation format for clinical guidelines. [1] Represented guidelines can be executed using a guideline execution engine.

The format has several versions as it has been improved. In 2003 GLIF3 was introduced.

Use of third party workflow engine as a guideline execution engine

Some commercial electronic health record systems use a workflow engine to execute clinical guidelines. RetroGuide [2] and HealthFlow [3] are examples of such an approach.

See also

Related Research Articles

<span class="mw-page-title-main">Health informatics</span> Computational approaches to health care

Health informatics is the study and implementation of computer structures and algorithms to improve communication, understanding, and management of medical information. It can be view as branch of engineering and applied science.

PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintain the database as part of the Entrez system of information retrieval.

<span class="mw-page-title-main">Electronic health record</span> Digital collection of patient and population electronically stored health information

An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

<span class="mw-page-title-main">Medical guideline</span> Document with the aim of guiding decisions and criteria in healthcare

A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements on best practice in healthcare. A healthcare provider is obliged to know the medical guidelines of their profession, and has to decide whether to follow the recommendations of a guideline for an individual treatment.

A radiological information system (RIS) is the core system for the electronic management of imaging departments. The major functions of the RIS can include patient scheduling, resource management, examination performance tracking, reporting, results distribution, and procedure billing. RIS complements HIS and PACS, and is critical to efficient workflow to radiology practices.

The Unified Medical Language System (UMLS) is a compendium of many controlled vocabularies in the biomedical sciences. It provides a mapping structure among these vocabularies and thus allows one to translate among the various terminology systems; it may also be viewed as a comprehensive thesaurus and ontology of biomedical concepts. UMLS further provides facilities for natural language processing. It is intended to be used mainly by developers of systems in medical informatics.

Biomedical text mining refers to the methods and study of how text mining may be applied to texts and literature of the biomedical domain. As a field of research, biomedical text mining incorporates ideas from natural language processing, bioinformatics, medical informatics and computational linguistics. The strategies in this field have been applied to the biomedical literature available through services such as PubMed.

<span class="mw-page-title-main">XPDL</span>

The XML Process Definition Language (XPDL) is a format standardized by the Workflow Management Coalition (WfMC) to interchange business process definitions between different workflow products, i.e. between different modeling tools and management suites. XPDL defines an XML schema for specifying the declarative part of workflow / business process.

<span class="mw-page-title-main">ICMJE recommendations</span>

The ICMJE recommendations are a set of guidelines produced by the International Committee of Medical Journal Editors for standardising the ethics, preparation and formatting of manuscripts submitted to biomedical journals for publication. Compliance with the ICMJE recommendations is required by most leading biomedical journals. Levels of real compliance are subject to debate. As of 9 January 2020, 5570 journals worldwide claim to follow the ICMJE recommendations.

A Clinical Trial Management System (CTMS) is a software system used by biotechnology and pharmaceutical industries to manage clinical trials in clinical research. The system maintains and manages planning, performing and reporting functions, along with participant contact information, tracking deadlines and milestones.

A workflow engine is a software application that manages business processes. It is a key component in workflow technology and typically makes use of a database server.

<span class="mw-page-title-main">Apache Taverna</span>

Apache Taverna was an open source software tool for designing and executing workflows, initially created by the myGrid project under the name Taverna Workbench, then a project under the Apache incubator. Taverna allowed users to integrate many different software components, including WSDL SOAP or REST Web services, such as those provided by the National Center for Biotechnology Information, the European Bioinformatics Institute, the DNA Databank of Japan (DDBJ), SoapLab, BioMOBY and EMBOSS. The set of available services was not finite and users could import new service descriptions into the Taverna Workbench.

Edward ("Ted") Hance Shortliffe is a Canadian-born American biomedical informatician, physician, and computer scientist. Shortliffe is a pioneer in the use of artificial intelligence in medicine. He was the principal developer of the clinical expert system MYCIN, one of the first rule-based artificial intelligence expert systems, which obtained clinical data interactively from a physician user and was used to diagnose and recommend treatment for severe infections. While never used in practice, its performance was shown to be comparable to and sometimes more accurate than that of Stanford infectious disease faculty. This spurred the development of a wide range of activity in the development of rule-based expert systems, knowledge representation, belief nets and other areas, and its design greatly influenced the subsequent development of computing in medicine.

<span class="mw-page-title-main">OpenMRS</span>

OpenMRS is a collaborative open-source project to develop software to support the delivery of health care in developing countries.

<span class="mw-page-title-main">Apache ODE</span>

Apache ODE is a software coded in Java as a workflow engine to manage business processes which have been expressed in the Web Services Business Process Execution Language (WS-BPEL) via a website. It was made by the Apache Software Foundation and released in a stable format on March 23, 2018. The software principally communicates with one or more Web services, sending and receiving messages, manipulating data and handling exceptions (errors) as defined by any given process. The engine is capable of running both long and short living processes to coordinate all the services that make up a service or application (orchestration).

The GELLO Expression Language was started in 2001 and introduced in 2002; in 2005, GELLO was adopted as an international standard by Health Level Seven International and ANSI for a decision support language. GELLO Release 2 was completed and approved by ANSI in June 2010. The GELLO specifications have been developed in coordination with the HL7 Clinical Decision Support TC (CDSTC)

The PICO process is a mnemonic used in evidence-based practice to frame and answer a clinical or health care related question, though it is also argued that PICO "can be used universally for every scientific endeavour in any discipline with all study designs". The PICO framework is also used to develop literature search strategies, for instance in systematic reviews.

Clinical point of care (POC) is the point in time when clinicians deliver healthcare products and services to patients at the time of care.

Translational bioinformatics (TBI) is a field that emerged in the 2010s to study health informatics, focused on the convergence of molecular bioinformatics, biostatistics, statistical genetics and clinical informatics. Its focus is on applying informatics methodology to the increasing amount of biomedical and genomic data to formulate knowledge and medical tools, which can be utilized by scientists, clinicians, and patients. Furthermore, it involves applying biomedical research to improve human health through the use of computer-based information system. TBI employs data mining and analyzing biomedical informatics in order to generate clinical knowledge for application. Clinical knowledge includes finding similarities in patient populations, interpreting biological information to suggest therapy treatments and predict health outcomes.

tranSMART

tranSMART is an open-source data warehouse designed to store large amounts of clinical data from clinical trials, as well as data from basic research, so that it can be interrogated together for translational research. It is also designed to be used by many people, across organizations. It was developed by Johnson & Johnson, in partnership with Recombinant Data Corporation. The platform was released in Jan 2012 and has been governed by the tranSMART Foundation since its initiation in 2013. In May 2017, the tranSMART Foundation merged with the i2b2 Foundation to create an organization with the key mission to advance the field of precision medicine.

References

  1. "Guideline Representation Page: GLIF 2.0, 3.4, 3.5 Specifications". Stanford University, School of Medicine, InterMed Collaboratory.
  2. Huser, V.; Narus, S. P.; Rocha, R. A. (2010). "Evaluation of a flowchart-based EHR query system: A case study of RetroGuide". Journal of Biomedical Informatics. 43 (1): 41–50. doi:10.1016/j.jbi.2009.06.001. PMC   2840619 . PMID   19560553.
  3. Huser V, Rasmussen LV, Oberg R, Starren JB (2011), "Implementation of workflow engine technology to deliver basic clinical decision support functionality", BMC Med Res Methodol, 11: 43, doi: 10.1186/1471-2288-11-43 , PMC   3079703 , PMID   21477364

Further reading