Abstract
Healthcare Information Technology (HIT) is a dynamically evolving industry due to continuous advancements in healthcare technologies. This necessitates the availability of highly dynamic applications that accommodate frequent changes in business logic. The automation of Clinical Decision Support (CDS) in particular is most liable to changes in health business logic or rules. In terms of system’s architecture, there is a need to separate business logic and rules from the implementation/functionality of the Electronic Health Record (EHR) application, providing processes and rules as reusable components. We propose an architecture utilizing rule-based technologies to facilitate Decision Support to promptly adapt business logic changes, that are reflected immediately in application behavior. This allows real-time and robust CDS for the physician at point of care. Our rule-based implementation (Business Process Modelling Notation (BPMN)+Rules) was successfully used to emulate Clinical workflows, using as an example, the NICE Lung Cancer Clinical Guideline (CG121) as a test scenario.
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References
Lewis, S.J., Orland, B.I.: The importance and impact of evidence-based medicine. J. Manag. Care Pharm. 10(5. suppl A), S3–S5 (2004)
Sittig, D., Wright, A., Osheroff, J.A., Middletone, B., Jteich, J., Ash, J., et al.: Grand challenges in clinical decision support. J. Biomed. Inform. 41(2), 387–392 (2008)
Tierney, W.M., Overhage, J.M., Takesue, B.Y.: Computerizing guidelines to improve care and patient outcomes: The example of heart failure. J. Am. Med. Inform. Assoc. 2, 316–322 (1995)
Vissers, M.C., Hasman, A., van der Linden, C.J.: Impact of a protocol processing system (ProtoVIEW) on clinical behaviour of residents and treatment. Int. J. Biomed. Comput. 42, 143–150 (1996)
Kawamoto, K., Houlihan, C.A., Balas, E.A., Lobach, D.F.: Improving clinical practice using clinical decision support systems: A systematic review of trials to identify features critical to success. BMJ (2005)
Boyer, J., Hafedh, M.: Agile Business Rule Development: Process, Architecture and JRule Examples. Springer, Heidelberg (2011)
Service Component Architecture, OASIS Standard, https://www.oasis-open.org/committees/tc_home.php?wg_abbrev=sca-j
Tolven eCHR. Tolven Inc. (2014), http://home.tolven.org/
JBoss Switchyard, http://www.jboss.org/switchyard
Davis, J.: Open Source SOA. Manning Publications Co., Greenwick (2009)
OMG, Business Process Model And Notation (BPMN) Version 2.0 (2011)
Clinical Decision Support Service (CDSS), http://www.omg.org/spec/CDSS/1.0/
HL7 Virtual Medical Record for Clinical Decision Support, http://www.hl7.org/implement/standards/product_brief.cfm?product_id=271
National Institute for Health and Care Excellence (The diagnosis and treatment of Lung Cancer) (CG121) NICE, London (2013), http://www.nice.org.uk/CG121
Paterno, M.D., Goldberg, H.S., Simonaitis, L., Dixon, B.E., Wright, A., et al.: Using a service oriented architecture approach to clinical decision support: Performance results from two CDS Consortium demonstrations. In: AMIA Annu. Symp. Proc. 2012, pp. 8–690 (2012)
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Aziz, A., Rodriguez, S., Chatwin, C. (2014). From Guidelines to Practice: Improving Clinical Care through Rule-Based Clinical Decision Support at the Point of Care. In: Bikakis, A., Fodor, P., Roman, D. (eds) Rules on the Web. From Theory to Applications. RuleML 2014. Lecture Notes in Computer Science, vol 8620. Springer, Cham. https://doi.org/10.1007/978-3-319-09870-8_13
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DOI: https://doi.org/10.1007/978-3-319-09870-8_13
Publisher Name: Springer, Cham
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