An object-oriented framework for the development of computer-based guideline implementations

Clinical practice guidelines provide a means of directing medical care towa rds clinically appropriate and cost-effective interventions. A direct relat ionship exists between the integration of a guideline into clinical workflo w and the effectiveness of the guideline in influencing clinicians' behavio r. Computer-based guideline implementations, used at the point-of-care, acc omplish this integration. Employing object-oriented technologies, we propos e a framework of reusable components for the development of guideline imple mentation systems. We have identified eight information management services that are common to such systems. Our framework integrates these services a nd their respective reusable components into clinical workflow to promote t he development of comprehensive guideline implementation systems, which sho uld ultimately enhance guideline compliance and the overall quality of care .