Guideline execution engine: Difference between revisions

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A '''Guidelineguideline Executionexecution Engineengine''' is a [[computer program]] which can interpret a [[guideline (medical)|clinical guideline]] represented in a computerized format and perform actions towards the user of an [[electronic medical record]].

A Guidelineguideline Executionexecution Engineengine needs to communicate with a host [[Clinicalclinical information system]]. [[virtualVirtual Medical Record|vMR]] (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 ==

Delivering the inferred engine recommendations or impacts to the host Clinical information system has to carefully respect current workflow of the clinicians (physicians, nurses, clerks, etc.)

The following modules are generally needed for any engine:

* interface to Clinicalclinical Informationinformation Systemsystem

== Architecture of Guideline Execution Engine ==

The following modules are generally needed for any engine

* interface to Clinical Information System

* new guidelines loading module

* guideline interpreter module

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== Guideline Interchange Format ==

The ''[[Guideline Interchange Format]] (GLIF)'' is a computer representation format for [[clinical guideline]]s.<ref>{{cite web |url=http://mis.hevra.haifa.ac.il/~morpeleg/Intermed/ |title=Guideline Representation Page: GLIF 2.0, 3.4, 3.5 Specifications |work=Stanford University, School of Medicine, InterMed Collaboratory }}</ref> 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<ref name=eval>{{Cite journal | last1 = Huser | first1 = V. | last2 = Narus | first2 = S. P. | last3 = Rocha | first3 = R. A. | doi = 10.1016/j.jbi.2009.06.001 | title = Evaluation of a flowchart-based EHR query system: A case study of RetroGuide | journal = Journal of Biomedical Informatics | volume = 43 | issue = 1 | pages = 41–50 | year = 2010 | pmid = 19560553 | pmc =2840619}}</ref> and HealthFlow<ref name=hf2010>{{citation|pmc=3079703|title=Implementation of workflow engine technology to deliver basic clinical decision support functionality|journal=BMC Med Res Methodol.|year=2011|volume= 11|page= 43|doi=10.1186/1471-2288-11-43|pmid=21477364|vauthors=Huser V, Rasmussen LV, Oberg R, Starren JB}}</ref> are examples of such an approach.

Some commercial Electronic Health Record systems use a [[workflow engine]] to execute clinical guidelines. RetroGuide<ref name=eval>{{Cite journal

| last1 = Huser | first1 = V.

| last2 = Narus | first2 = S. P.

| last3 = Rocha | first3 = R. A.

| doi = 10.1016/j.jbi.2009.06.001

| title = Evaluation of a flowchart-based EHR query system: A case study of RetroGuide☆

| journal = Journal of Biomedical Informatics

| volume = 43

| issue = 1

| pages = 41–50

| year = 2010

| pmid = 19560553

| pmc =2840619

}}</ref> and HealthFlow<ref name=hf2010>{{citation|pmc=3079703|title=Implementation of workflow engine technology to deliver basic clinical decision support functionality|journal=BMC Med Res Methodol.|year=2011|volume= 11|page= 43|doi=10.1186/1471-2288-11-43|pmid=21477364|vauthors=Huser V, Rasmussen LV, Oberg R, Starren JB}}</ref> are examples of such an approach.

== See also ==

* [[Arden syntax]]

* [[Medical algorithm]]

*[[Electronic medical record]]

*[[Clinical practice guideline]]

*[[Medical algorithm]]

*[[Arden syntax]]

*[[Healthcare workflow]]

*[[Glif]]

*[[RetroGuide]]

== References ==

<references/>

== ExternalFurther linksreading ==

*{{cite journal |vauthors=Wang D, Peleg M, Tu SW, etal |title=Design and implementation of the GLIF3 guideline execution engine |journal=J Biomed Inform |volume=37 |issue=5 |pages=305–18 |date=October 2004 |pmid=15488745 |doi=10.1016/j.jbi.2004.06.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S1532046404000668}} [http://bmir.stanford.edu/file_asset/index.php/940/BMIR-2004-1008.pdf (PDF)]

*{{cite journal |vauthors=Ram P, Berg D, Tu S, etal |title=Executing clinical practice guidelines using the SAGE execution engine |journal=Stud Health Technol Inform |volume=107 |issue=Pt 1 |pages=251–5 |year=2004 |pmid=15360813 }}

*{{cite journal |vauthors=Tu SW, Campbell J, Musen MA |title=The structure of guideline recommendations: a synthesis |journal=AMIA Annu Symp Proc |volume= |issue= |pages=679–83 |year=2003 |pmid=14728259 |pmc=1480008 }} [http://bmir.stanford.edu/file_asset/index.php/1511/BMIR-2003-0966.pdf (PDF)]

*{{cite journal |vauthors=Tu SW, Musen MA |title=A flexible approach to guideline modeling |journal=Proc AMIA Symp |volume= |issue= |pages=420–4 |year=1999 |pmid=10566393 |pmc=2232509 }} [http://bmir.stanford.edu/file_asset/index.php/211/BMIR-1999-0789.pdf (PDF)]