SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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L. Monney1 , A. F. Lamas1 , J. R. Haag1

1Datamed SA, Ch. de la Redoute 9, 1752 Villars-sur-Glâne, Switzerland

The integration of guideline-knowledge into clinical practice is an essential step toward a better healthcare system. Computer-interpretable guidelines can deliver decision support to healthcare providers and thus improve the quality of medical practice. Decision support can be used for general plans for patient management, as well as for more specific tasks, such as clinical laboratory analysis.
The goal of this project was to develop an execution engine for computer-based clinical laboratory guidelines. The architecture of the guidelines is derived from the Intermed common GuideLine Interchange Format (GLIF) model(1) and the Guideline Element Model (GEM)(2). GLIF and GEM were both developed for the representation of general clinical guidelines, GLIF by a collaboration among the universities of Stanford, Harvard and Columbia and GEM by a team at Yale University.
The execution engine can access guidelines from the knowledge-base. The engine is then able to traverse these guidelines by evaluating each step against the patient data, which are acquired from the user and/or from the patient database. Finally, recommendations are suggested to the user based on the step evaluation.
This expert system has been specifically developed for future usage in clinical laboratory medicine. However, the general nature of the guideline flowchart architecture offers the opportunity to use this system in any field where protocols play an important role, such as quality control or medical diagnosis.

1. Peleg M, Boxwala AA, Tu S, Zeng Q, Ogunyemi O, Wang D, Patel VL, Greenes RA, Shortliffe EH. J Am Med Inform Assoc. 2004, 11(1):1-10
2. Shiffman, R. N., Karras, B. T., Agrawal, A., Chen, R., Marenco, L. and Nath, S. J Am Med Inform Assoc. 2000, 7: 488-498

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