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Re: Decision Support Providers


Thanks, Tony!

I failed to find any mentioned CDS standards (or in fact design
specifications since it's probably not a SDO ;-) published by Anvita.
Perhaps others have better luck. What's interesting here is this is
perhaps yet another example of creating a new 'standard' for the
purpose of CDS.

In the chemotherapy guideline paper, we studied half-dozen well-known
guideline representation formats and concluded that to overcome the
interoperability problem between EHRs and CDSS, guidelines can be
expressed with EHR models directly together with rules and process
definitions. Since both the CDS rule triggering conditions and
recommendations (order sets, dose adjustments, lab requests etc) are
in fact either based on data from EHR or candidate EHR entries, it
seems reasonable to express guidelines with EHR models.

Rules are needed to express guideline logic. The fact that openEHR has
no its own rule language or an ambition to develop one is a very good
thing. This means external rule language can be plugged into openEHR
framework when necessary. Well-established rule engines like CLIPS,
Jess or JBoss Drools are good candidates here. What we need to do in
the openEHR community is to develop a good mechanism allowing rule
plug-ins, e.g. necessary syntax in template/archetype for attachment
of rules.

I will try to document some of our experiences on the wiki in the 
coming months.

Cheers,
Rong

On 29 June 2010 14:57, Tony Shannon <tony.shannon@nhs.net> wrote:
> Many thanks Rong,
>
> The approach you outline which reuses archetypes and templates from 
> EHR
> models resonates as a logical way to tackle this.
>
> John Halamka mentions in his blog...
> "Thus, Anvita has defined clinical decision support (CDS) standards to
> transmit decision support recommendations from the service provider 
> back
> to the EHR. I am unaware any widely implemented standards that do this
> today. "
>
> Can you comment on his quote/article?
>
> Also can you say some more about the rules element of your work..
>
> Many thanks,
>
> Tony
>
> Dr. Tony Shannon
> Consultant in Emergency Medicine, Leeds Teaching Hospitals
> Clinical Lead for Informatics,    Leeds Teaching Hospitals
> Chair, Clinical Review Board, openEHR Foundation
> +44.789.988 5068            tony.shannon@nhs.net
>

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