Structured representation for core elements of common clinical decision support interventions to facilitate knowledge sharing.
At present, there are no widely accepted, standard approaches for representing computer-based clinical decision support (CDS) intervention types and their structural components. This study aimed to identify key requirements for the representation of five widely utilized CDS intervention types: alerts and reminders, order sets, infobuttons, documentation templates/forms, and relevant data presentation. An XML schema was proposed for representing these interventions and their core structural elements (e.g., general metadata, applicable clinical scenarios, CDS inputs, CDS outputs, and CDS logic) in a shareable manner. The schema was validated by building CDS artifacts for 22 different interventions, targeted toward guidelines and clinical conditions called for in the 2011 Meaningful Use criteria. Custom style sheets were developed to render the XML files in human-readable form. The CDS knowledge artifacts were shared via a public web portal. Our experience also identifies gaps in existing standards and informs future development of standards for CDS knowledge representation and sharing.
Clinical Informatics Research & Development, Partners HealthCare System, Inc., Wellesley, MA, USA.
Li
L
Zhou
Tonya
T
Hongsermeier
Aziz
A
Boxwala
Janet
J
Lewis
Kensaku
K
Kawamoto
Saverio
S
Maviglia
Douglas
D
Gentile
Jonathan M
JM
Teich
Roberto
R
Rocha
Douglas
D
Bell
Blackford
B
Middleton
D020000:Decision Support Systems, Clinical / Q000592:standards*; D004282:Documentation / Q000592:standards*; D017408:Guidelines as Topic; D033181:Information Dissemination / Q000379:methods*; D050316:Medical Order Entry Systems / Q000592:standards*; D017010:Reminder Systems / Q000592:standards*; D012984:Software / Q000592:standards*; D012985:Software Design; D014481:United States; D014584:User-Computer Interface