EGADSS: a clinical decision support system for use in a service-oriented architecture

Abstract

Almost one in ten of every hospital admission in Canada is caused by our own health care system. Steps must be taken to reduce medical errors. One proven way to reduce medical errors is through the use of Clinical Decision Support (CDS) Systems. CDS systems provide point of care alerts to clinicians that are based on pre-defined rules (e.g. if patient allergic to drug then do not administer drug). a significant issue with CDS Systems is that they are very expensive for a hospital to develop and maintain, thereby preventing widespread adoption. We have designed and implemented EGADSS, the Evidence-based Guideline And Decision Support System. EGADSS is designed for use as part of a service-oriented architecture. By centralising the development and maintenance of a CDS system (possibly by a governing authority), more providers can afford to adopt them. Indeed we have interfaced EGADSS with two clients systems. In addition, EGADSS can easily be adopted by other EMRs. We also evaluated the suitability of Arden Syntax, HL7's Clinical Guideline Encoding standard, for use in a service-oriented CDS environment. We identify several language features that should be standardised. Most importantly, we show how to build a CDS system for use in a service-oriented architecture. EGADSS has been tested with 5 test guidelines and several patient profiles to verify that it behaves correctly.