GLIF3: The Evolution of a Guideline Representation Format
Mor Peleg, Ph.D.1, Aziz A. Boxwala, M.B.B.S., Ph.D.2, Omolola Ogunyemi, Ph.D.2, Qing Zeng, Ph.D.2, Samson Tu, M.S.1, Ronilda Lacson, M.D.2, Elmer Bernstam, M.D., M.S.E.1, Nachman Ash, M.D.2, Peter Mork, B.A.1, Lucila Ohno-Machado, MD, Ph.D.2, Edward H. Shortliffe, M.D., Ph.D.3, Robert A. Greenes, M.D., Ph.D.2
1Stanford Medical Informatics, Stanford University School of Medicine, Stanford, CA
2Decision Systems Group, Harvard Medical School, Brigham & Women’s Hospital, Boston, MA
3Department of Medical Informatics, Columbia University, New York, NY

The Guideline Interchange Format (GLIF) is a language for structured representation of guidelines. It was developed to facilitate sharing clinical guide-lines. GLIF version 2 enabled modeling a guideline as a flowchart of structured steps, representing clinical actions and decisions. However, the attributes of structured constructs were defined as text strings that could not be parsed, and such guidelines could not be used for computer-based execution that requires automatic inference. GLIF3 is a new version of GLIF designed to support computer-based execution. GLIF3 builds upon the framework set by GLIF2 but augments it by introducing several new constructs and extending GLIF2 constructs to allow a more formal definition of decision criteria, action specifi-cations and patient data. GLIF3 enables guideline encoding at three levels: a conceptual flowchart, a computable specification that can be verified for logical consistency and completeness, and an imple-mentable specification that can be incorporated into particular institutional information systems.