Transforming evidence-based clinical guidelines into implementable clinical decision support services: the CAREPATH...

Area of Science:

• Health Informatics
• Clinical Decision Support
• Geriatric Care

Background:

• Older adults with multimorbidity, including mild cognitive impairment or dementia, require integrated, patient-centered care.
• Multidisciplinary teams need tools to create personalized care plans aligned with evidence-based guidelines.
• Automating clinical guidelines through clinical decision support (CDS) services is crucial for consistency and efficiency.

Purpose of the Study:

• To develop a methodology for generating implementable specifications for CDS services.
• To translate evidence-based clinical guidelines into automated CDS services.
• To support the CAREPATH project in creating a patient-centered integrated care platform.

Main Methods:

• A co-creation framework involving clinical experts and software engineers was established.
• A repeatable and traceable method was used to translate guideline narratives into CDS specifications.
• International standards like CDS-Hooks and HL7 FHIR were leveraged for interoperability.

Main Results:

• Implementable specifications for 65 CDS services were created, automating a consensus guideline from 25 evidence-based guidelines.
• 296 CDS rules were defined, with parameters linked to FHIR resources and international code systems.
• 346 CDS Cards were generated, providing guidance for care plan activities and goal suggestions, integrated into the CAREPATH platform.

Conclusions:

• The methodology provides a systematic and replicable process for generating CDS specifications.
• Collaboration between clinical and technical experts enhances the quality and relevance of specifications.
• Traceability ensures adherence to guideline recommendations and facilitates stakeholder tracking.