title: Linking guidelines to Electronic Health Record design for improved chronic disease management.
abstract: The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.
authors.affiliation: Advanced Computing Research Centre, University of South Australia.
authors.forename: Sistine A
authors.initials: SA
authors.lastname: Barretto
authors.forename: Jim
authors.initials: J
authors.lastname: Warren
authors.forename: Andrew
authors.initials: A
authors.lastname: Goodchild
authors.forename: Linda
authors.initials: L
authors.lastname: Bird
authors.forename: Sam
authors.initials: S
authors.lastname: Heard
authors.forename: Markus
authors.initials: M
authors.lastname: Stumptner
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D048909:Diabetes Complications; D019468:Disease Management; D006751:Hospital Information Systems; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D019982:Organizational Case Studies; D017410:Practice Guidelines as Topic; D012984:Software