Section 5: Decision Support, Knowledge Representation and Management: Free and Open Source Enabling Technologies for Patient-Centric, Guideline-Based Clinical Decision Support: A Survey

T. Y. Leong; K. Kaiser; S. Miksch

doi:10.1055/s-0038-1638529

Yearbook of Medical Informatics, Table of Contents

Yearb Med Inform 2007; 16(01): 74-86
DOI: 10.1055/s-0038-1638529

Survey

Georg Thieme Verlag KG Stuttgart

Section 5: Decision Support, Knowledge Representation and Management: Free and Open Source Enabling Technologies for Patient-Centric, Guideline-Based Clinical Decision Support: A Survey

T. Y. Leong

¹Medical Computing Laboratory, School of Computing, National University of Singapore, Singapore

,

K. Kaiser

²Institute of Software Technology and Interactive Systems, Vienna University of Technology, Austria

³Department of Information and Knowledge Engineering, Danube University Krems, Austria

,

S. Miksch

²Institute of Software Technology and Interactive Systems, Vienna University of Technology, Austria

› Author Affiliations

Abstract

Summary

Objectives

Guideline-based clinical decision support is an emerging paradigm to help reduce error, lower cost, and improve quality in evidence-based medicine. The free and open source (FOS) approach is a promising alternative for delivering cost-effective information technology (IT) solutions in health care. In this paper, we survey the current FOS enabling technologies for patient-centric, guideline-based care, and discuss the current trends and future directions of their role in clinical decision support.

Methods

We searched PubMed, major biomedical informatics websites, and the web in general for papers and links related to FOS health care IT systems. We also relied on our background and knowledge for specific subtopics. We focused on the functionalities of guideline modeling tools, and briefly examined the supporting technologies for terminology, data exchange and electronic health record (EHR) standards.

Results

To effectively support patient-centric, guideline-based care, the computerized guidelines and protocols need to be integrated with existing clinical information systems or EHRs. Technologies that enable such integration should be accessible, interoperable, and scalable. A plethora of FOS tools and techniques for supporting different knowledge management and quality assurance tasks involved are available. Many challenges, however, remain in their implementation.

Conclusions

There are active and growing trends of deploying FOS enabling technologies for integrating clinical guidelines, protocols, and pathways into the main care processes. The continuing development and maturation of such technologies are likely to make increasingly significant contributions to patient-centric, guidelinebased clinical decision support.

Keywords

Guideline-based clinical decision support - free and open source - knowledge management - representation - standards - electronic health records - clinical guideline - modeling

Full Text

References

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