Applying openEHR’s Guideline Definition Language to the SITS international stroke treatment registry: a European retrospective observational study

Abstract

BackgroundInteroperability standards intend to standardise health information, clinical practice guidelines intend to standardise care procedures, and patient data registries are vital for monitoring quality of care and for clinical research. This study combines all three: it uses interoperability specifications to model guideline knowledge and applies the result to registry data.MethodsWe applied the openEHR Guideline Definition Language (GDL) to data from 18,400 European patients in the Safe Implementation of Treatments in Stroke (SITS) registry to retrospectively check their compliance with European recommendations for acute stroke treatment.ResultsComparing compliance rates obtained with GDL to those obtained by conventional statistical data analysis yielded a complete match, suggesting that GDL technology is reliable for guideline compliance checking.ConclusionsThe successful application of a standard guideline formalism to a large patient registry dataset is an important step toward widespread implementation of computer-interpretable guidelines in clinical practice and registry-based research. Application of the methodology gave important results on the evolution of stroke care in Europe, important both for quality of care monitoring and clinical research.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0401-5) contains supplementary material, which is available to authorized users.

Standardised data reporting from pre-hospital advanced airway management – a nominal group technique update of the Utstein-style airway template

“…The results from consensus processes such as ours are not the endpoint, as dissemination and implementation of the results into clinical service are the final aims [ 49 ]. A few EMS have successfully implemented the original template into clinical service; however, endorsement by internationally recognised airway societies, research groups, or key EMS stakeholders, along with interoperable health information systems, may be vital to secure a broad implantation of the airway template in international EMS [ 8 , 50 , 51 ].…”

Business Process Model and Notation and openEHR Task Planning for Clinical Pathway Standards in Infections: Critical Analysis

“…Moreover, TP allows for the specification of complex times in medication orders (eg, "3 times a day before meals" [51]), and it is conceived as a clinical process navigator, empowering users to perform ad hoc modifications at the time of execution to reflect real-time changes and supporting auditing, reporting, and billing to analyze task performance, execution, and eventual deviations from the original plan. Although openEHR has a wide coverage as a research area [52][53][54], the TP specification has been used in fewer studies [55][56][57] and is still under development. The contributions of our work to support our hypothesis of the native suitability of clinical-oriented BPM formalisms for infection CPs are as follows: (1) identification of key features required for modeling infection CPs, as laid out in the literature, the JHH CGs, and the successive BPMN extensions; (2) theoretical analysis of how TP addresses the identified key features; (3) a case study to empirically show the native TP adequacy by modeling typical CR-BSI infection patterns using TP; and (4) analysis and proposal of potential extensions of the current version of TP for improved modeling of infection CPs and possibly of other complex CPs.…”

What Role Can Process Mining Play in Recurrent Clinical Guidelines Issues? A Position Paper

“…On this track, the Guideline Definition Language (GDL) [22] is a rule-based language that allows to directly reference openEHR archetypes and allows the seamless integration of CDSS modules with openEHR-based EHRs [23]. Both GDL and the openEHR Task Planning models are designed to run over openEHR compliant repositories and when the EHR contains data stored in format different from openEHR, a preprocessing stage can be performed for making it openEHR compliant [81].…”

“…For workflow semantics, several languages have also been proposed. In openEHR, the openEHR Task Plan uses ADL for specifying workflows [21], another language for CDS rules is the Guideline Definition Language developed by Chen et al [22,23]. In the CIGs realm, workflows have been traditionally represented using two main alternative approaches.…”