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Modelling clinical narrative as computable knowledge: The NICE computable implementation guidance project.

Philip Scott1, Michaela Heigl2, Charles McCay3,4

  • 1Institute of Management & Health University of Wales Trinity Saint David Carmarthen Wales UK.

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|October 20, 2023
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Summary
This summary is machine-generated.

The UK National Institute for Health and Care Excellence (NICE) project successfully adapted the WHO Digital Adaptation Kit (DAK) to create computable knowledge from clinical guidelines. This facilitates digital health tools and improves healthcare consistency.

Keywords:
clinical decision support systemscomputable knowledgedecision modellingpractice guideline

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Area of Science:

  • Health Informatics
  • Clinical Knowledge Management
  • Digital Health Implementation

Background:

  • Translating narrative clinical guidelines into computable knowledge presents a significant challenge.
  • The UK National Institute for Health and Care Excellence (NICE) Content Advisory Board (CAB) aims to enhance clinical decision support, audit, and guideline development.
  • A transition towards natively digital content production by NICE was explored.

Purpose of the Study:

  • To explore technical approaches for transitioning NICE recommendations into computable knowledge.
  • To establish a framework for developing traceable, consistent, and high-fidelity digital clinical guidance.
  • To guide software developers and support local practice audits.

Main Methods:

  • The NICE Computable Implementation Guidance (NCIG) project was established following a 'collaborathon'.
  • Workstreams focused on user stories, information modeling, and output formats.
  • The WHO Digital Adaptation Kit (DAK) was adopted as a technology-agnostic method for logical modeling.

Main Results:

  • An intermediate logical model, using the WHO DAK, proved more achievable than direct technical standards.
  • The DAK was adapted to model user scenarios, processes, data elements, and decision logic.
  • Future work will address indicators and implementation in primary care systems.

Conclusions:

  • The WHO DAK, with modifications, is a promising approach for creating technology-neutral logical specifications of NICE recommendations.
  • Implementing concurrent computable modeling involves complex but tractable methodological and cultural considerations.
  • Successful implementation requires strong leadership and commitment.