Project BriefOpen Competition 3 - Information TechnologyStandards-Based Interoperable Guideline SystemsDevelop advanced software tools and technologies to enable the widespread creation, distribution, and application of electronic clinical practice guidelines that will provide clinicians with patient-specific care recommendations at the time and point of care. Sponsor: IDX Systems Corporation1001 Fourth Avenue PlazaSuite 1500 Seattle, WA 98154-1144
A multi-disciplinary team led by IDX Systems Corporation proposes to develop the technical infrastructure that will enable healthcare organizations to develop, deploy and share clinical practice guidelines. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Guidelines synthesize the medical knowledge and offer formal recommendations for patient care. Many experts believe that widespread adherence to clinical practice guidelines could significantly improve patient safety, quality of care, improve outcomes, and reduce healthcare costs. To date, however, adherence to guidelines has been seriously hampered by their lack of availability at the time and place of care. Studies have shown that physician compliance of clinical guidelines improves dramatically when patient-appropriate guidelines are presented when care is being delivered. Practically, this is only possible when guidelines are embedded electronically in a clinical information system. Few institutions have developed in-house technologies to deploy guidelines via clinical information systems. These efforts usually require significant resources for the implementation of even a few guidelines. Further, implemented guidelines cannot generally be shared with other institutions or systems. IDX and the project participants intend to develop a suite of tools to enable the widespread use of patient-specific clinical practice guidelines. The main elements include an "Interoperable Guideline Model" capitalizing on existing guideline modeling knowledge to provide a standard format for electronic representation of clinical knowledge; a "Guideline Workbench" software application to author, edit and archive guidelines using the guideline model standard format; and "Deployment Application" software that will integrate guidelines written in the standard format into existing, standards-compliant clinical information systems. Many complex problems will be solved during this project, including the unambiguous representation of knowledge for most guideline types; capturing that representation within the clinical workflow; mapping guideline concepts and terms to local information systems; and translating standard-based guideline rules into system-specific logic rules. Project participants plan to develop the basic software tools and, as proof of concept, implement them at different institutions to demonstrate that the same patient data and physician actions at each site generate the same recommendations and warnings. The partners sought ATP support because of the complexity of the task, the high-risk/high-reward nature of the project and the broad commercial-academic partnership involved. IDX will serve as Principal Investigator. Other participants include Apelon, Inc. (Ridgefield, Conn.); IHC Health Services, Inc. (Salt Lake City, Utah); Mayo Clinic Rochester (Rochester, Minn.); Stanford University (Stanford, Calif.); and the University of Nebraska Medical Center (Omaha, Neb.). If fully successful, the project should significantly improve patient safety and reduce healthcare costs through widespread application of the highest standards of clinical practice. Preventable medical errors are estimated to cost the U.S. $17 billion, and lead to between 44,000 and 98,000 premature deaths, annually.
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