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Related Experiment Videos

Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation.

Richard N Shiffman1, George Michel, Abdelwaheb Essaihi

  • 1Yale Center for Medical Informatics, 300 George Street, Suite 501, New Haven, CT 06511, USA. richard.shiffman@yale.edu

Journal of the American Medical Informatics Association : JAMIA
|June 10, 2004
PubMed
Summary

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This study presents a systematic process for translating clinical practice guidelines into electronic health record systems. This approach enhances guideline implementation by converting document knowledge into computable formats for clinical decision support.

Area of Science:

  • Health Informatics
  • Clinical Decision Support

Background:

  • A significant gap exists between published clinical practice guidelines and their practical implementation in healthcare settings.
  • Existing methods for translating guideline knowledge into actionable clinical tools are often inefficient and complex.

Purpose of the Study:

  • To describe a systematic process for translating document-based knowledge from clinical practice guidelines into workflow-integrated clinical decision support systems.
  • To make explicit the steps required for effective guideline implementation.

Main Methods:

  • The Guideline Elements Model (GEM) is utilized to represent guideline knowledge in a computable format.
  • Key steps include guideline selection, text markup, deabstraction, disambiguation, rule verification, and integration into electronic health records.

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Main Results:

  • The process was demonstrated by translating the National Heart, Lung, and Blood Institute's asthma management guideline into a decision support system within the Logician EHR.
  • This systematic approach facilitates the conversion of guideline recommendations into executable statements and actionable interventions.

Conclusions:

  • Leveraging guideline documents as a knowledge source ensures authentic knowledge translation and simplifies implementation.
  • This framework is expected to improve the understanding of guideline implementation activities and promote more effective clinical practice.