Application of a conceptual framework for the modelling and execution of clinical guidelines as networks of concurrent processes

We present a conceptual framework for modelling clinical guidelines as networks of concurrent processes. This enables the guideline to be partitioned and distributed at run-time across a knowledge-based telemedicine system, which is distributed by definition but whose exact physical configuration can only be determined after design-time by considering, amongst other factors, the individual patient's needs. The framework was applied to model a clinical guideline for gestational diabetes mellitus and to derive a prototype that executes the guideline on a smartphone. The framework is shown to support the full development trajectory of a decision support system, including analysis, design and implementation

Use of the virtual medical record data model for communication among components of a distributed decision-support system

MobiGuide is a distributed decision-support system (DSS) that provides decision support for patients and physicians. Patients receive support using a light-weight Smartphone DSS linked to data arriving from wearable monitoring devices and physicians receive support via a web interface connected to a backend DSS that has access to an integrated personal health record (PHR) that stores hospital EMR data, monitoring data, and recommendations provided for the patient by the DSSs. The patient data model used by the PHR and by all the system components that interact in a service-oriented architecture is based on HL7's virtual medical record (vMR) model. We describe how we used and extended the vMR model to support communication between the system components for the complex workflow needed to support guidance of patients any time everywhere