Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation.

摘要: Objective: A gap exists between the information contained in published clinical practice guidelines and knowledge that are necessary to implement them. This work describes a process systematize make explicit translation of document-based into workflow-integrated decision support systems. Design: approach uses Guideline Elements Model (GEM) represent guideline knowledge. Implementation requires number steps translate text computable format integrate workflow. The include: (1) selection specific recommendations for implementation, (2) markup text, (3) atomization, (4) deabstraction (5) disambiguation recommendation concepts, (6) verification rule set completeness, (7) addition explanations, (8) building executable statements, (9) specification origins variables insertions recommended actions, (10) definition action types associated beneficial services, (11) choice interface components, (12) creation requirement specification. Results: authors illustrate these component processes using examples drawn from recent experience translating National Heart, Lung, Blood Institute's on management chronic asthma system operates within Logician electronic health record system. Conclusion: Using document as source promotes authentic domain reduces overall complexity implementation task. From this framework, we believe better understanding activities involved will emerge.