Executing clinical practice guidelines

• US 8,275,631 B2
• Filed: 09/15/2004
• Issued: 09/25/2012
• 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: Ram, Prabhu, Berg, David R., Thrun, John M., Wu, Bing, Taunk, Chandresh, Abarbanel, Robert M., Mansfield, James Guy
• Primary Examiner(s): Morgan, Robert
• Assistant Examiner(s): Kanaan, Maroun
• Application Number:
  US10/942,285
• Publication Number:
  US 20050108049A1
• Time in Patent Office: 2,932 Days
• Field of Search: 705/2, 705/3
• 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. A guideline execution system including an automated guideline execution engine for executing a clinical practice guideline (CPG) based on patient medical data stored in a clinical information system (CIS), the system comprising:

a storage device coupled to a bus, the storage device including a set of executable code; and

a processor coupled to the bus, wherein the processor executes the set of executable code, effectuating the following elements;

a core engine configured in the guideline execution engine, wherein the core engine executes the CPG, wherein the CPG is a standardized clinical practice workflow for a medical procedure or practice;

a binding module configured in the guideline execution engine, wherein the binding module obtains medical data stored in the CIS responsive to execution of the CPG, and further implements an action responsive to execution of the CPG based on the medical data obtained from the CIS, wherein the binding module includes a remote data access module and a local data access module, further wherein the local data access module provides or overrides clinical functionality in the CIS;

an actions interface coupling the guideline execution engine and the CIS, wherein the actions interface receives and transfers requests from the guideline execution engine to the CIS during the execution of the CPG and receives and transfers responses from the CIS to the guideline execution engine, wherein the actions interface communicates with the guideline execution engine in a first protocol and the CIS in a second protocol, wherein the remote data access module in the binding module formulates the request to the action interface and forwards responses to the core engine;

an event listener, wherein the event listener monitors changes in and additions to medical data stored in the CIS for a triggering event, and further wherein the event listener sends an event notification of the triggering event to the guideline execution engine; and

an event processing module in the guideline execution engine, wherein the even processing module receives the event notification and activates the core engine to execute the CPG responsive to the event notification.

2. The system of claim 1, comprising a concept handler, wherein the concept handler obtains terminology data for a term included in the clinical practice guideline from a terminology server and returns the terminology data to the core engine for execution of the term.

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

4. The system of claim 1, comprising a reading module, wherein the reading module parses the guideline and determining triggering events based on the guideline.

5. The system of claim 1, wherein the binding module receives requests for medical data from the core engine, retrieves requested medical data through an interface layer form a plurality of sources, and provides retrieved requested medical data to the core engine to support execution of the guideline.

6. The system of claim 5, wherein the binding module creates a request for the medical data formatted according to a web services protocol supported by the interface layer.

7. The system of claim 1, wherein the binding module generates 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.