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PROTOCOLS FOR MEDICAL PROCEDURES AND THERAPIES

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Throughout the world, major changes are taking place in the delivery of medical services driven by the need to ensure more consistent quality of care, while containing costs. Advanced information technologies will play a major role in these changes. The Imperial Cancer Research Fund and InferMed Ltd. have developed Arezzo® technology, based on the PROforma language, specifically for the expression of medical information for use by computers. Arezzo® Composer and Performer provide a versatile suite of tools for developing aids to medical decision making and clinical process management. A number of prototypes and products to support patient care have been built and objective evaluations have shown potential for significant clinical benefit and better use of resources. Arezzo is a new technology, developed by the Imperial Cancer Research Fund in collaboration with InferMed Ltd., for specifying and enacting clinical guidelines and protocols. It is a technology, which has been designed to support the management of medical procedures and clinical decision making at the point of care. It consists of: -A formal knowledge representation language, capable of capturing clinical guidelines in a form, which can be interpreted by a computer. -A graphical editor (COMPOSER), which provides an associated notation to capture the structure of a guideline as a series of clinical tasks and their attributes, and generate an executable specification. Four kinds of task are supported: 'plans' (sets of tasks), 'decisions' (involving a choice between options), 'actions' (clinical procedures) and 'enquiries' (actions returning required information). -The PERFORMER, the engine that tests and executes guidelines. It can prompt the user to perform actions, collect data, carry out procedures and make decisions. During guideline enactment, the PERFORMER maintains a local database of patient data, which can be modified by the user. Specific conditions can be evaluated using the guideline specification.

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