A design model for computer-based guideline implementation based on information management services

clinical practice guidelines must be implemented effectively if they are to influence the behavior of clinicians. The authors describe a model for com puter-based guideline implementation that identifies eight information mana gement services needed to integrate guideline-based decision support with c linical workflow. Recommendation services determine appropriate activities in specific clinical circumstances. Documentation services involve data cap ture. Registration services integrate demographic and administrative data. Explanation services enhance the credibility of automated recommendations b y providing supportive evidence and rating the quality of evidence. Calcula tion services measure time intervals, suggest medication dosages, and perfo rm other computational tasks. Communication services employ standards for i nformation transfer and provide data security. Effective presentation servi ces facilitate understanding of complex data, clarify trends, and format wr itten materials (including prescriptions) for patients. Aggregation service s associate outcomes with specific guideline interventions. The authors pro vide examples of the eight services that make up the model from five eviden ce-based practice parameters developed by the American Academy of Pediatric s.