Expressing and Sharing Clinical Decision Support Rules Using openEHR Archetypes

Rong Chena,b, Iago Corbala,c

a Cambio Healthcare Systems, Sweden

b Health Informatics Centre, LIME, Karolinska Institutet, Sweden

c Institute of Biomedical Research of A Coruña (INIBIC), Spain



Expressing and sharing computerized clinical decision support (CDS) rules across languages, organizations and technical platforms has been an evasive goal. Lack of commonly shared semantically well-defined clinical information models and flexible support for various terminology resources have been identified as two main challenges for sharing detailed clinical rules between sites. The newly proposed Guideline Definition Language (GDL) is a formal language designed to represent clinical knowledge for single decision making. GDL is designed to be natural language- and reference terminology- agnostic by leveraging the designs of openEHR Reference Model and Archetype Model. The design specification of GDL is submitted to the openEHR community for review and its reference implementation is released as open source software[1]. The design specifications of GDL and the experience of its first implementation will be shared with the audience. Several GDL-based rules from different clinical domains will be demonstrated. Finally, the tutorial attendants will have the opportunity to model several GDL rules using the open source GDL editor, following step-by-step instructions.

Outline of topics

  1. Background introduction of rule-based CDS, and the challenges in expressing and sharing of rules
  2. Introducing GDL, and its design and implementation as an exemplary technology that is designed to be agnostic to natural language and reference terminologies
  3. Introducing the semantic underpinning of GDL, naming the openEHR archetypes as an abstraction of clinical information models
  4. Introducing the open source GDL-editor, the GUI-based authoring tool for creating GDL rules with examples
  5. Step-by-step tutorial on how to create several GDL rules based on clinical requirements and execute rules directly inside GDL editor


Learning objectives

  1. To understand the main barriers of sharing and expressing computerized clinical decision support (CDS) rules across countries, organizations and technical platforms;
  2. To learn the openEHR Guideline Definition Language (GDL) as an exemplary technology of overcoming the above mentioned barriers for sharing CDS rules and to use the open source GDL-Editor to create CDS rules based on realistic clinical requirements;
  3. To get hands-on experiences in authoring structured clinical information models and performing terminology bindings, both are necessary for interoperable CDS rules.


Targeted audience

Clinicians, informatics specialists and CDS application developers who would like to learn how to express clinical decision support rules in a natural-language and reference-terminology agnostic manner. Hospital CIO, CMIO and regional health IT managers who would like to be aware of the latest development in CDS in particular how openEHR archetypes can be utilized in scalable CDS development.National authority and standards development organizations representatives that would like to be informed about the possible ways of sharing CDS content across country borders and language barriers using openEHR archetypes and reference terminology as building blocks – all based on proven semantic EHR standards.