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From Guidelines to Practice: Improving Clinical Care through Rule-Based Clinical Decision Support at the Point of Care

機(jī)譯：從指南到實(shí)踐：在護(hù)理點(diǎn)通過基于規(guī)則的臨床決策支持來改善臨床護(hù)理

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Healthcare Information Technology (HIT) is a dynamically evolving industry due to continuous advancements in healthcare technologies. This necessitates the availability of highly dynamic applications that accommodate frequent changes in business logic. The automation of Clinical Decision Support (CDS) in particular is most liable to changes in health business logic or rules. In terms of system's architecture, there is a need to separate business logic and rules from the implementation/functionality of the Electronic Health Record (EHR) application, providing processes and rules as reusable components. We propose an architecture utilizing rule-based technologies to facilitate Decision Support to promptly adapt business logic changes, that are reflected immediately in application behavior. This allows real-time and robust CDS for the physician at point of care. Our rule-based implementation (Business Process Modelling Notation (BPMN)+Rules) was successfully used to emulate Clinical workflows, using as an example, the NICE Lung Cancer Clinical Guideline (CG121) as a test scenario.
機(jī)譯：由于醫(yī)療技術(shù)的不斷進(jìn)步，醫(yī)療信息技術(shù)（HIT）是一個動態(tài)發(fā)展的行業(yè)。這需要提供高度動態(tài)的應(yīng)用程序，以適應(yīng)業(yè)務(wù)邏輯中的頻繁更改。特別是臨床決策支持（CDS）的自動化最容易導(dǎo)致健康業(yè)務(wù)邏輯或規(guī)則的更改。在系統(tǒng)架構(gòu)方面，需要將業(yè)務(wù)邏輯和規(guī)則與電子病歷（EHR）應(yīng)用程序的實(shí)現(xiàn)/功能分開，以提供可重復(fù)使用的流程和規(guī)則。我們提出一種利用基于規(guī)則的技術(shù)的體系結(jié)構(gòu)，以促進(jìn)決策支持迅速適應(yīng)業(yè)務(wù)邏輯更改，這些更改將立即反映在應(yīng)用程序行為中。這允許醫(yī)生在護(hù)理點(diǎn)進(jìn)行實(shí)時，強(qiáng)大的CDS。我們基于規(guī)則的實(shí)施（業(yè)務(wù)流程建模符號（BPMN）+規(guī)則）已成功用于模擬臨床工作流程，并以NICE肺癌臨床指南（CG121）為例作為測試場景。

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