Guideline execution engine

A guideline execution engine is a computer program which can interpret a clinical guideline represented in a computerized format and perform actions towards the user of an electronic medical record.

A guideline execution engine needs to communicate with a host clinical information system. Virtual Medical Record (vMR) is one possible interface which can be used.

The engine's main function is to manage instances of executed guidelines of individual patients.

Architecture

The following modules are generally needed for any engine:

• interface to clinical information system
• new guidelines loading module
• guideline interpreter module
• clinical events parser
• alert/recommendations dispatch

Guideline Interchange Format

The Guideline Interchange Format (GLIF) is a computer representation format for clinical guidelines.^[1] Represented guidelines can be executed using a guideline execution engine.

The format has several versions as it has been improved. In 2003 GLIF3 was introduced.

Use of third party workflow engine as a guideline execution engine

Some commercial electronic health record systems use a workflow engine to execute clinical guidelines. RetroGuide^[2] and HealthFlow^[3] are examples of such an approach.

See also

• Arden syntax
• Medical algorithm

References

1. "Guideline Representation Page: GLIF 2.0, 3.4, 3.5 Specifications". Stanford University, School of Medicine, InterMed Collaboratory.
2. Huser, V.; Narus, S. P.; Rocha, R. A. (2010). "Evaluation of a flowchart-based EHR query system: A case study of RetroGuide". Journal of Biomedical Informatics. 43 (1): 41–50. doi:10.1016/j.jbi.2009.06.001. PMC 2840619. PMID 19560553.
3. Huser V, Rasmussen LV, Oberg R, Starren JB (2011), "Implementation of workflow engine technology to deliver basic clinical decision support functionality", BMC Med Res Methodol, 11: 43, doi:10.1186/1471-2288-11-43, PMC 3079703, PMID 21477364

Further reading

• Wang D, Peleg M, Tu SW, et al. (October 2004). "Design and implementation of the GLIF3 guideline execution engine". J Biomed Inform. 37 (5): 305–18. doi:10.1016/j.jbi.2004.06.002. PMID 15488745.
• Ram P, Berg D, Tu S, et al. (2004). "Executing clinical practice guidelines using the SAGE execution engine". Stud Health Technol Inform. 107 (Pt 1): 251–5. PMID 15360813.
• Tu SW, Campbell J, Musen MA (2003). "The structure of guideline recommendations: a synthesis". AMIA Annu Symp Proc. 2003: 679–83. PMC 1480008. PMID 14728259.
• Tu SW, Musen MA (1999). "A flexible approach to guideline modeling". Proc AMIA Symp: 420–4. PMC 2232509. PMID 10566393.