Medical Logic Modules White Paper [PDF} - IDS-Healthcare

MICROMEDEX ®MEDICAL LOGIC MODULESAdditionally, MICROMEDEX has assembled anexceptional Advisory Board consisting of pioneersin rule-based reminder systems. Robert Raschke,M.D., M.S., Robert Jenders, M.D., M.S., HarmScherpbier, M.D., and Carol Broverman, Ph.D.have been involved with the American Societyfor Testing and Materials (ASTM) and HealthLevel 7 (HL7) to help develop the standards forknowledge representation.When considering the knowledge represented bythe medical logic modules, the key determinantof quality is the strength of the developmentprocess. MICROMEDEX uses a defined processthat assigns an MLM author/developer and submitsthe draft MLM to internal and externalexperts for review. The MLM is then subjected toquality assurance (QA) functional and technicaltesting, including testing by the rules engine vendors.After release, the MLM undergoes a clientreview process and continued post-implementationevaluation.Long-term maintenance of a knowledge base fora clinical decision support system can involve aconsiderable number of changes. Jenders andassociates [8] reported that over a seven-yearperiod, more than 5,000 changes were made to aclinical decision support system knowledge base.Healthcare enterprises facing the long-termmaintenance effort find considerable value inhaving MICROMEDEX manage the maintenanceof this knowledge base.SummaryMICROMEDEX Medical Logic Modules written inArden Syntax provide health enterprises with areadily implementable knowledge base of decisionsupport rules. The task of developing andmaintaining knowledge bases is labor-intensive.While healthcare enterprises will continue todevelop their own rules, those using ArdenSyntax-based rules engines will speed the implementationprocess with the MICROMEDEXMedical Logic Modules. MICROMEDEX will maintainthe knowledge base with information fromtrusted sources on a regular schedule as newinformation is released from the guideline developmentorganizations. An additional strength ofthis concept is the open architecture of ArdenSyntax, which allows the client institution to customizethese rules to local needs and preferences.[1] Linda T. Kohn, Janet M. Corrigan, and Molla S.Donaldson, Editors; To Err Is Human: Building a SaferHealth System, Committee on Quality of Health Carein America, Institute of Medicine.[2] Lazarou J, Pomeranz BH and Corey PN: Incidence ofadverse drug reactions in hospitalized patients – Ameta-analysis of prospective studies. JAMA 1998;279(15):1200-5.[3] Bates DW et al., Effect of computerized physicianorder entry and a team intervention on prevention ofserious medication errors, JAMA 1998; 280:1311-16.[4] Raschke RA et al., A Computer Alert System toPrevent Injury From Adverse Drug Events, JAMA 1998,280:1317-20.[5] Shaneyfelt TM, Mayo-Smith MF, Rothwangl J Areguidelines following guidelines? The methodologicalquality of clinical practice guidelines in the peerreviewedmedical literature. JAMA 1999 May 26;281(20): 1900-5.[6] Shortliffe, E, Toward a Sharable GuidelineRepresentation, An Invitational Workshop: TowardsRepresentations for Sharable Guidelines, March 3 - 4,2000, Boston, Massachusetts.[7] MICROMEDEX® Medical Logic Modules, accessedon 12.9.2000.[8] Jenders RA, Evolution of a Knowledge Base for aClinical Decision Support System Encoded in ArdenSyntax. Proceedings AMIA Annual Symposium 1998:558-562.Dr. Dulcey writes medical logic modules and consultsfor healthcare enterprises implementing clinical decisionsupport systems that use Arden Syntax. He hassixteen years of clinical experience as a generalinternist and worked for Siemens Health Solutionsdeveloping and implementing the Siemens RulesEngine. Dr. Dulcey is a member of the Clinical DecisionSupport Committee and the Arden Syntax SpecialInterest Group of Health Level 7. He can be reached atjohn.dulcey@alum.mit.edu.(800) 525-9083Intl Tel +1 303 486 6444www.micromedex.comAll MICROMEDEX Systems are Copyright © 1974-2002 MICROMEDEX Thomson Healthcare.All rights reserved. All product and brand names are trademarks or registered trademarks of their respective companies.HC-15738 MLM Dulcey paper 08/02