Guide project

Clinical Guideline Management System


Objectives

The NewGuide Project aims at the creation of a multilevel architecture to foster an effective medical knowledge management. “Effective” means that the goal of the project, in addition to the computerized knowledge representation, is to support also:

 •  different views of the formalized knowledge, with different levels of abstraction/details but also with different goals (for example the patient view is different from the physician view: if a GL for a chronic condition suggests to take a blood sample every fifteen days, the physician view will concern the interpretation of the examination results, while the patient needs a remind and a facility to book the test);
 •  the use of the formalized knowledge for generating health care processes able to respond to the environment stimuli and patient condition mutations (connection to the electronic patient record and to the workflow system);
 •  the generation of new knowledge (elicitation of tacit knowledge) promoting and monitoring the human contribute, that has to gain a central role in the system: this is very difficult in presence of rigid health care pathways and rigid user interaction;
 •  evaluation and control strategies for the validation of the elicited knowledge and for the rating of the guideline based health care path (feedback);
 •  reusability and sharing of statically and dynamically generated knowledge components.
 •  the communication between the Guideline Management System (GlMS) managing the medical knowledge and the Careflow Management System (CfMS) managing the organizational knowledge.

Description of the work

NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a multi-user environment, and a reporting system storing the guidelines logs in order to be able to completely trace any individual physician guideline-based decision process. There is a system “central level” that maintains official versions of the guidelines, and local Healthcare Organizations may download and implement them according to their needs. The architecture has been implemented using the Java 2 Enterprise Edition (J2EE) platform. Simple Object Access Protocol (SOAP) is the key factor for the integration of NewGuide with healthcare legacy systems. It allows maintaining unchanged legacy user interfaces and connecting the system with whatever electronic patient record.

Technology

  • J2SE
  • J2EE
  • JBOSS
  • Terminologies (LOINC,ICD9)
  • Oracle Database