Lessons Learned from Adapting a Generic Narrative Diabetic-Foot Guideline to an Institutional Decision-Support System

Mor PELEG[1], Dongwen WANG2, Adriana FODOR3, 4, Sagi KEREN5 and Eddy KARNIELI3, 4

[1]Department of Management Information Systems, University of Haifa, Israel

2Biomedical Informatics Program, University of Rochester, NY

3Institute of Endocrinology, Diabetes & Metabolism, Rambam Medical Center and 4Galil Center, Technion–Israel Institute of Technology, Israel

5Department of Computer Science, University of Haifa, Israel

Abstract. Clinical guidelines usually need to be adapted to fit local practice before they can be actually used by clinicians. Reasons for adaptation include variations of institution setting such as type of practice and location, availability of resources, differences in patient populations, local policies, and practice patterns. When a guideline is implemented for clinical decision support and integrated with an institution's clinical information system, the data model of the local electronic medical record (EMR) and the data actually collected and stored in it also influence the guideline's adaptation. The purpose of this work is: (1) to characterize a tool-supported process for guideline encoding that addresses local adaptation and EMR integration, and (2) to identify the types of changes in guideline encoding during the local adaptation process.


Keywords: Clinical guidelines, computer-interpretable guidelines, local adaptation, EMR integration, GLIF3



[1] Department of Management Information Systems, University of Haifa, Haifa, Israel, 31905, E-mail: morpeleg@mis.hevra.haifa.ac.il