Friday, 1 February 2013
Clinical Decision Support Modelling
As part of working on clinical decision support systems over the years a constant tension remains between approaches focused on modelled or programmatic implementation of knowledge/rules.
Of course these classifications are really a sliding scale; I can produce models from programmatic statements and I can produce executable programs from a model. As a models capability to represent concepts is enhanced and made more generic - so to the complexity of the model or the possible combinations of concepts increases. This is implicitly a trade off.
I also find myself getting back to the basic questions of how to access a representation of a health record in a standardised fashion for writing my rules. VMR, CDA, openEHR or FHIR? Which concept terminology should I use? SNOMED, what ever is local? or invent my own reference terms (à la openCDS)?
This leads me back to the position that really we are still at the point of defining service interfaces as a priority. Definition and agreements on interactions available and payload content within a domain of use are #1. Specific determination of capabilities of a decision support service and the ability provide appropriate input information and receive responses in useful forms (including structured and rendered) give me enough to chew on for now... still...