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Proceedings of the AMIA Symposium logoLink to Proceedings of the AMIA Symposium
. 1999:770–774.

Distributing knowledge maintenance for clinical decision-support systems: the "knowledge library" model.

A Geissbuhler 1, R A Miller 1
PMCID: PMC2232510  PMID: 10566464

Abstract

The maintenance of knowledge-rich clinical decision-support systems is challenging, in particular in the complex setting of a large academic medical center. Distributing the maintenance tasks to the source of expertise can address scalability, accuracy and currency issues. It also helps to foster a more global sense of ownership among the system users. The knowledge maintenance model must provide processes and tools to deal with a wide range of stakeholders (resident and attending physicians, consulting specialists, other care providers, case managers, ancillary departments), with knowledge embedded in legacy departmental systems, and with the continuous evolution of the content and form of the knowledge base. We describe and illustrate the "knowledge library" model in use at Vanderbilt University Medical Center for the distributed maintenance of the integrated knowledge base that drives the WizOrder clinical decision-support, physician order entry, and notes capture system.

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Selected References

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  1. Forsythe D. E., Buchanan B. G., Osheroff J. A., Miller R. A. Expanding the concept of medical information: an observational study of physicians' information needs. Comput Biomed Res. 1992 Apr;25(2):181–200. doi: 10.1016/0010-4809(92)90020-b. [DOI] [PubMed] [Google Scholar]
  2. Geissbühler A., Miller R. A. A new approach to the implementation of direct care-provider order entry. Proc AMIA Annu Fall Symp. 1996:689–693. [PMC free article] [PubMed] [Google Scholar]
  3. Haug P. J., Gardner R. M., Tate K. E., Evans R. S., East T. D., Kuperman G., Pryor T. A., Huff S. M., Warner H. R. Decision support in medicine: examples from the HELP system. Comput Biomed Res. 1994 Oct;27(5):396–418. doi: 10.1006/cbmr.1994.1030. [DOI] [PubMed] [Google Scholar]
  4. Hripcsak G., Ludemann P., Pryor T. A., Wigertz O. B., Clayton P. D. Rationale for the Arden Syntax. Comput Biomed Res. 1994 Aug;27(4):291–324. doi: 10.1006/cbmr.1994.1023. [DOI] [PubMed] [Google Scholar]
  5. Jenders R. A., Huang H., Hripcsak G., Clayton P. D. Evolution of a knowledge base for a clinical decision support system encoded in the Arden Syntax. Proc AMIA Symp. 1998:558–562. [PMC free article] [PubMed] [Google Scholar]
  6. McDonald C. J., Murray R., Jeris D., Bhargava B., Seeger J., Blevins L. A computer-based record and clinical monitoring system for ambulatory care. Am J Public Health. 1977 Mar;67(3):240–245. doi: 10.2105/ajph.67.3.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Overhage J. M., Mamlin B., Warvel J., Warvel J., Tierney W., McDonald C. J. A tool for provider interaction during patient care: G-CARE. Proc Annu Symp Comput Appl Med Care. 1995:178–182. [PMC free article] [PubMed] [Google Scholar]
  8. Pryor T. A. Development of decision support systems. Int J Clin Monit Comput. 1990 Jul;7(3):137–146. doi: 10.1007/BF02915578. [DOI] [PubMed] [Google Scholar]
  9. Pryor T. A., Gardner R. M., Clayton P. D., Warner H. R. The HELP system. J Med Syst. 1983 Apr;7(2):87–102. doi: 10.1007/BF00995116. [DOI] [PubMed] [Google Scholar]
  10. Pryor T. A., Hripcsak G. The Arden syntax for medical logic modules. Int J Clin Monit Comput. 1993 Nov;10(4):215–224. doi: 10.1007/BF01133012. [DOI] [PubMed] [Google Scholar]
  11. Pryor T. A. The use of medical logic modules at LDS hospital. Comput Biol Med. 1994 Sep;24(5):391–395. doi: 10.1016/0010-4825(94)90007-8. [DOI] [PubMed] [Google Scholar]

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