Executing clinical practice guidelines

• US 20050108049A1
• Filed: 09/15/2004
• Published: 05/19/2005
• Est. Priority Date: 09/15/2003
• Status: Active Grant

• Current Assignee: VVC Holding Corporation (Athenahealth Incorporated)
• Original Assignee: IDX Systems Corporation (General Electric Company)
• Inventors: Wu, Bing, Thrun, John M., Taunk, Chandresh, Ram, Prabhu, Mansfield, James Guy, Abarbanel, Robert M., Berg, David R.
• Granted Patent: US 8,275,631 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A clinical practice guideline can be implemented using a guideline execution engine. The engine can interpret the clinical practice guideline, obtain medical data stored in a clinical information system (CIS), and implement an action in response to execution of the clinical practice guideline based on medical data for a patient obtained from the CIS. The use of the CIS medical data in guideline execution beneficially allows the guideline to be tightly integrated into the real-time workflow of a clinician in a clinical setting and to provide patient-specific guideline recommendations. A VMR/actions interface facilitates communications between a guideline execution system and a CIS by processing a request for medical data from the guideline execution engine and implementing actions on the CIS requested by the guideline execution engine.

Claims

1. An automated guideline execution engine for executing a clinical practice guideline based on patient medical data stored in a clinical information system (CIS), the engine comprising:

a core engine for executing the clinical practice guideline; and

a binding module for obtaining medical data stored in the CIS responsive to execution of the clinical practice guideline and for implementing an action responsive to execution of the clinical practice guideline based on the medical data obtained from the CIS.

2. The engine of claim 1 comprising a concept handler for obtaining terminology data for a term included in the clinical practice guideline from a terminology server and returning the terminology data to the core engine for execution of the term.

3. The engine of claim 1 comprising a function handler for processing a portion of the guideline not intended for execution by the core engine and returning a result based on the processing to the core engine.

4. The engine of claim 1 comprising an event processing module for receiving a notification of a triggering event and activating the core engine to execute the guideline responsive to the notification.

5. The engine of claim 4, wherein the notification is provided by an event listener that monitors changes in medical data stored in the CIS and detects events based on the changes.

6. The engine of claim 1 comprising a reading module for parsing the guideline and determining triggering events based on the guideline.

7. The engine of claim 1, wherein the binding module is configured to receive requests for medical data from the core engine, retrieve requested medical data through an interface layer from a plurality of sources, and provide retrieved requested medical data to the core engine to support execution of the guideline.

8. The engine of claim 7, wherein the binding module is configured to create a request for the medical data formatted in accordance with a web services protocol supported by the interface layer.

9. The engine of claim 1, wherein the binding module is configured to generate a request to perform an action in the CIS formatted according to a web services protocol published by an interface layer between the engine and the CIS.

10. A virtual medical record (VMR)/actions interface system for facilitating communications between a guideline execution engine and a clinical information system (CIS) and carrying out a request received from the guideline execution engine, the system comprising:

a services module for, responsive to the request comprising a request for data stored in the CIS, processing the request, generating a data request to the CIS, and returning the requested medical data to the guideline execution engine; and

an actions module for, responsive to the request comprising a request to implement an action in the CIS, processing the request, generating an action request to the CIS, and returning a confirmation of the action to the guideline execution engine.

11. The VMR/actions interface system of claim 10, further comprising a utility module for creating a context for a data or action request from the VMR/actions interface to the CIS that specifies access credentials of the guideline execution engine.

12. The VMR/actions interface system of claim 10, wherein the request from the guideline execution engine is made in accordance with a web services protocol supported by the VMR/actions interface.

13. The VMR/actions interface system of claim 12, wherein the web services protocol supported by the VMR/actions interface is published to the guideline execution engine.

14. The VMR/actions interface system of claim 10, wherein the actions module is configured to supply a notification to the CIS for delivery to a clinician.

15. The VMR/actions interface system of claim 10, wherein the actions module is configured to schedule an event in the CIS.

16. The VMR/actions interface system of claim 10, wherein the actions module is configured to insert data into a patient record in the CIS.

17. A method of executing a clinical practical guideline with respect to a patient, the method comprising the steps of:

sending a request for patient data stored in a clinical information system (CIS) responsive to execution of the guideline;

receiving the requested patient data;

sending a request to perform an action responsive to execution of the guideline; and

receiving a confirmation of performance of the requested action.

18. The method of claim 17, the method comprising

receiving a command signal from an external application through an engine access interface;

and

executing the guideline responsive to the command signal.

19. The method of claim 18, wherein the command signal comprises an instruction to enroll a patient with the guideline.

20. The method of claim 17, comprising:

generating the request for patient data in accordance with a web services method supported by an interface communicatively coupled to the CIS;

sending the request for patient data to the interface; and

receiving the requested patient data from the interface.

21. The method of claim 20, further comprising:

receiving the confirmation of performance of the requested action from the interface.

22. The method of claim 17, further comprising:

testing execution of the guideline;

receiving the requested patient data from a testing module; and

receiving the confirmation of performance of the requested action from the testing module.