title: Managing care pathways combining SNOMED CT, archetypes and an electronic guideline system.
abstract: Today electronic clinical guideline systems exist, but they are not well integrated with electronic health records. This paper thus proposes that the patient's "position" in the pathway during the patient journey should be made visible to all involved healthcare parties and the patient. This requires that the generic knowledge, which is represented in the guidelines, is combined with the patient specific information - and then made accessible for all relevant parties. In addition to the decision support provided by the guideline system documentation support can be provided by templates based on archetypes. This paper provides a proposal for how the guideline system and the EHR can be integrated by the use of archetypes and SNOMED CT. SNOMED CT provides the common reference terminology and the semantic links between the systems. The proposal also includes the use of a National Patient Index for storing data about the patient's position in the pathway and for sharing this information by all involved parties.
authors.affiliation: MEDIQ - Medical Informatics and Quality Management, Denmark.
authors.forename: Knut
authors.initials: K
authors.lastname: Bernstein
authors.forename: Ulrich
authors.initials: U
authors.lastname: Andersen
mesh_terms: D000555:Ambulatory Care Information Systems; D003628:Database Management Systems; D016208:Databases, Factual; D020000:Decision Support Systems, Clinical; D003718:Denmark; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D016247:Information Storage and Retrieval; D016490:Integrated Advanced Information Management Systems; D033183:Interdisciplinary Communication; D016347:Medical Records Systems, Computerized; D017410:Practice Guidelines as Topic; D039061:Systematized Nomenclature of Medicine; D017749:Total Quality Management