Clinical decision support systems for managing subscriptions to rule content
View Patent ↗A system includes a centralized repository for tracking rule content and managing subscriptions to rule content by organizations and providers utilizing the system; a rule-evaluation server for receiving requests for rule-evaluations for specific patients, wherein the server determines content needing to be evaluated and retrieves the content to be used; a rule engine for performing the evaluations, wherein content, patient data, and rule evaluation parameters are provided to the engine, and the engine returns recommendations triggered by the evaluation, if any; an aggregator for aggregating recommendations from multiple sources, detecting and coordinating related recommendations, and applying configuration settings based on the patient and/or provider in context; and a client component for coordinating communication between an electronic health records system, the server, and the aggregator.
1. A clinical decision support system (CDS System), comprising:
(a) a CDS manager, loaded on one or more electronic devices, comprising a centralized repository for tracking rule content and managing subscriptions to rule content by organizations and providers utilizing the CDS system;
(b) a CDS server, loaded on one or more electronic devices, comprising a rule-evaluation server, wherein clients utilizing the CDS system communicate with the CDS server to request rule-evaluation for specific patients, and wherein the CDS server communicates with the CDS manager to determine which content needs to be evaluated and to retrieve the actual content to be used;
(c) a CDS rule engine, loaded on one or more electronic devices, comprising an engine responsible for performing the evaluation, wherein the content, patient data, and rule evaluation parameters are provided to the engine, and the engine returns recommendations triggered by the evaluation, if any;
(d) a recommendation aggregator, loaded on one or more electronic devices, comprising a component responsible for aggregating recommendations from multiple sources, detecting and eliminating duplicates, and applying configuration settings based on the patient and/or provider in context; and
(e) a CDS client, loaded on one or more electronic devices, comprising a client component responsible for coordinating communication between the consuming rule engine, the CDS server, and the recommendation aggregator;
(f) wherein at least some rule content is parameterized in that rule content corresponding to one or more specific rules contains parameters associated with default or user-specified values, rather than values hard-coded as part of the rule content, and the system provides a user interface which allows a provider to customize such parameters by specifying a particular value for a particular parameter.
2. The system of claim 1 , wherein the parameterized rule content includes parameters that allow a user to customize a value that determines whether a recommendation is triggered.
3. The system of claim 2 , wherein the system is configured to allow a user to customize a value, for a specific patient, that determines whether a recommendation is triggered for that specific patient, without altering rule content for other patients.
4. The system of claim 2 , wherein the system is configured to allow a provider to customize a value that determines whether a recommendation is triggered for his or her entire practice.
5. The system of claim 1 , wherein the parameterized rule content includes parameters that allow a user to customize recommendation output.
6. The system of claim 5 , wherein the system is configured to allow a user to customize a value, for a specific patient, that customizes recommendation output for that specific patient, without altering rule content for other patients.
7. The system of claim 5 , wherein the system is configured to allow a user to customize a value that customizes recommendation output for his or her entire practice.
8. The system of claim 1 , wherein the parameterized rule content includes parameters that allow a user to customize recommendation output for a specific patient or practice.
9. The system of claim 1 , wherein, as part of a call-level interface exposed by the CDS server and utilized by the CDS client, the system makes available a description of the patient data that must be provided in order to successfully perform an evaluation.
10. The system of claim 9 , wherein the information is cached so that the call only needs to be made once per electronic health record per provider.
11. The system of claim 1 , wherein the system comprises a platform for the expression and delivery of clinical decision support logic on a subscription basis.
12. The system of claim 1 , wherein the only information that is sent is that which will actually be used by the content to which a provider is subscribed.
13. The system of claim 1 , wherein the format used to encode clinical decision support logic specifies logic at the functional level such that any need for language syntax is obviated.
14. The system of claim 1 , wherein clinical decision support is provided in real-time to a provider with a patient in a point-of-care setting.