HELEN, a Modular Framework for Representing and Implementing Clinical Practice Guidelines

S. Skonetzki; H.-J. Gausepohl; M. van der Haak; S. Knaebel; O. Linderkamp; T. Wetter

doi:10.1055/s-0038-1633885

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2004; 43(04): 413-426
DOI: 10.1055/s-0038-1633885

Original Article

Schattauer GmbH

HELEN, a Modular Framework for Representing and Implementing Clinical Practice Guidelines

Authors

S. Skonetzki

¹Department of Medical Informatics, Heidelberg University Medical Center, Germany
H.-J. Gausepohl

²Department of Neonatology, Heidelberg University Medical Center, Germany
M. van der Haak

¹Department of Medical Informatics, Heidelberg University Medical Center, Germany
S. Knaebel

²Department of Neonatology, Heidelberg University Medical Center, Germany
O. Linderkamp

²Department of Neonatology, Heidelberg University Medical Center, Germany
T. Wetter

¹Department of Medical Informatics, Heidelberg University Medical Center, Germany

Abstract

Summary

Objectives: In order to implement clinical practice guidelines for the Department of Neonatology of the Heidelberg University Medical Center we developed a modular framework consisting of tools for authoring, browsing and executing encoded clinical practice guidelines (CPGs).

Methods: Based upon a comprehensive analysis of literature, we set up requirements for guideline representation systems. Additionally, we analyzed further aspects such as the critical appraisal and known bridges and barriers for implementing CPGs. Thereafter we went through an evolutionary spiral model to develop a comprehensive ontology. Within this model each cycle focuses on a certain topic of management and implementation of CPGs.

Results: In order to bring the resulting ontology into practice we developed a framework consisting of a tool for authoring, a server for web-based browsing, and an engine for the execution of certain elements of CPGs. Based upon this framework we encoded and implemented several CPGs in varying medical domains.

Conclusions: This paper shall present a practical framework for both authors and implementers of CPGs. We have shown the fruitful combination of different knowledge representations such as narrative text and algorithm for implementing CPGs. Finally, we introduced a possible approach for the explicit adaptation of CPGs in order to provide institution-specific recommendations and to support sharing with other medical institutions.

Keywords

Clinical practice guidelines - representation - acquisition - implementation - local adaptation - execution - decision support

Full Text

References

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