From Narrative Therapeutic Guidelines to Decision Support: Design for Production Efficiency and Safety

This paper reports on a research project aimed at optimising the print and electronic production process of therapeutic guidelines and making the data elements and underlying logic machine-readable. We first describe a re-engineered guideline production system, SISMO (Single Input Source, Multiple Output), which has been devised and is currently being introduced into a guidelines production process. SISMO allows narrative text to be developed in a traditional manner, however a variety of print and electronic outputs can then be produced through XML and XSLT files. We then describe an Algorithmic Decision Support (ADS) server. The ADS server allows the execution of the reasoning that is implicit within the narrative of the guidelines and is intended to interface either with a user or an external system according to standard communication protocols.