A Process-Oriented Approach for Supporting Clinical Decisions for Infection Management

Clinical practice guidelines have proven to be a powerful means for improving and standardizing healthcare assistance and patient outcome. Despite the recent increase in their diffusion and the advances made towards their automation, most clinicians do not use guidelines at the point of care in their daily practice. Indeed, clinical decision support systems are often retrospective and complicated to use. To promote the extraction and use of the process-oriented knowledge encoded in clinical guidelines, we propose to seamlessly integrate different techniques in order to incorporate procedural and medical knowledge into an existing clinical decision support system. In detail, we employ the BPMN and DMN process and decision modeling standards to model certain critical parts of selected guidelines. The obtained diagrams are combined with production rules to measure the current progress of clinical practice with respect to the steps outlined in the guideline and to provide contextualized clinical decision support. Moreover, we introduce a timeline view of medical activities to foster both the planning of future care steps and the adaptation of the guideline to the needs of an individual patient. In this paper, we describe the novelties introduced in a clinical decision support system capable of visualizing guideline progress and of supporting clinical decisions in the context of antimicrobial stewardship programs.