Computer-Mediated Guideline Implementation Projects
Overview
AsthMonitor
Information Management Services Model
PalmAsthma
Object-Oriented Framework
We have devised an information management services model for the implementation of clinical practice guidelines. Briefly, the model comprises 8 components defined as follows:
- recommendation: the determination of appropriate, guideline-specified
activities that should occur under specific clinical circumstances
- documentation: the collection, recording, and storage of observations,
assessments, and interventions related to clinical care
- explanation: the provision of background information on decision variables
and guideline-specified actions (e.g., definitions, measures of quality or cost) and the
rationale that supports guideline recommendations, including evidence and literature
citations
- presentation: the creation of useful output from internal data stores
- registration: the recording and storage of administrative and demographic
data to uniquely identify the patient, provider(s) and encounter
- communication: the transmission and receipt of electronic messages between
the clinician and other information providers
- calculation: the manipulation of numeric and/or temporal data to derive
required information
- aggregation: the derivation of population-based information from individual patient data
A variety of methods may be used to incorporate each service in a computer-based guideline implementation. Although their inclusion should result in a more comprehensive, workflow-integrated system, individual services may be excluded from any specific application.
The information management services model can be used as a checklist for developers of computer-based guideline implementation solutions. Alternatively, the model provides constructs by which guideline implementations can be evaluated