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1.
J Am Med Inform Assoc ; 14(5): 589-98, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17600098

RESUMO

The SAGE (Standards-Based Active Guideline Environment) project was formed to create a methodology and infrastructure required to demonstrate integration of decision-support technology for guideline-based care in commercial clinical information systems. This paper describes the development and innovative features of the SAGE Guideline Model and reports our experience encoding four guidelines. Innovations include methods for integrating guideline-based decision support with clinical workflow and employment of enterprise order sets. Using SAGE, a clinician informatician can encode computable guideline content as recommendation sets using only standard terminologies and standards-based patient information models. The SAGE Model supports encoding large portions of guideline knowledge as re-usable declarative evidence statements and supports querying external knowledge sources.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Guias de Prática Clínica como Assunto/normas , Sistemas de Informação Hospitalar , Humanos , Bases de Conhecimento , Sistemas de Registro de Ordens Médicas , Modelos Teóricos , Software , Integração de Sistemas , Interface Usuário-Computador , Vocabulário Controlado
2.
Stud Health Technol Inform ; 107(Pt 1): 174-8, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15360798

RESUMO

The success of clinical decision-support systems requires that they are seamlessly integrated into clinical workflow. In the SAGE project, which aims to create the technological infra-structure for implementing computable clinical practice guide-lines in enterprise settings, we created a deployment-driven methodology for developing guideline knowledge bases. It involves (1) identification of usage scenarios of guideline-based care in clinical workflow, (2) distillation and disambiguation of guideline knowledge relevant to these usage scenarios, (3) formalization of data elements and vocabulary used in the guideline, and (4) encoding of usage scenarios and guideline knowledge using an executable guideline model. This methodology makes explicit the points in the care process where guideline-based decision aids are appropriate and the roles of clinicians for whom the guideline-based assistance is intended. We have evaluated the methodology by simulating the deployment of an immunization guideline in a real clinical information system and by reconstructing the workflow context of a deployed decision-support system for guideline-based care. We discuss the implication of deployment-driven guideline encoding for sharability of executable guidelines.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Imunização , Guias de Prática Clínica como Assunto , Tomada de Decisões Assistida por Computador , Humanos , Hipertensão/tratamento farmacológico , Sistemas Computadorizados de Registros Médicos , Modelos Teóricos , Estudos Retrospectivos , Software , Interface Usuário-Computador , Vocabulário Controlado
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