The PRODIGY Knowledge Architecture Requirements for Chronic Disease Management in Primary Care

1 Chronic disease management guidance should take account of successive consultations, which has implications for both the way knowledge is represented and for the way the Electronic Patient Record (EPR) represents temporal issues 2 The guidance model should not be totally dependent on data in the EPR since in practice this is often missing or incorrect 3 It should always be possible to revise the guidance offered in response to changed circumstances, as not all patient events can be anticipated, nor when they occur are they necessarily recorded on the EPR 4 Standardised coding of drugs and clinical concepts is needed, to facilitate authoring and distribution of a consistent set of guidance 5 It should be possible to rapidly develop and modify Knowledge Acquisition tools to support the authoring process in line with the developing guidance model. Knowledge authoring is a difficult problem, and the difficulty is compounded when the guidance model is unstable (i.e. under iterative development)