title: Automating Guidelines for Clinical Decision Support: Knowledge Engineering and Implementation.
abstract: As utilization of clinical decision support (CDS) increases, it is important to continue the development and refinement of methods to accurately translate the intention of clinical practice guidelines (CPG) into a computable form. In this study, we validate and extend the 13 steps that Shiffmanet al.5identified for translating CPG knowledge for use in CDS. During an implementation project of ATHENA-CDS, we encoded complex CPG recommendations for five common chronic conditions for integration into an existing clinical dashboard. Major decisions made during the implementation process were recorded and categorized according to the 13 steps. During the implementation period, we categorized 119 decisions and identified 8 new categories required to complete the project. We provide details on an updated model that outlines all of the steps used to translate CPG knowledge into a CDS integrated with existing health information technology.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA;; Stanford University, Stanford, CA.
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Tso
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Samson W
authors.initials: SW
authors.lastname: Tu
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Connie
authors.initials: C
authors.lastname: Oshiro
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Susana
authors.initials: S
authors.lastname: Martins
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Ashcraft
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Kaeli W
authors.initials: KW
authors.lastname: Yuen
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Amy
authors.initials: A
authors.lastname: Robinson
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA;; Stanford University, Stanford, CA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA;; Stanford University, Stanford, CA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Goldstein
mesh_terms: D002908:Chronic Disease; D020000:Decision Support Systems, Clinical; D006801:Humans; D017410:Practice Guidelines as Topic; D014481:United States; D014493:United States Department of Veterans Affairs