Design of a standards-based external rules engine for decision support in a variety of application contexts: Report of a feasibility study at partners healthcare system

This project explored functional requirements for an institution-wide method, at Partners HealthCare, for interpreting clinical knowledge for decision support. Such knowledge is currently incorporated in a variety of clinical applications, yet the methods of representation and of execution vary and the ability to author/edit the rules by human experts is limited. We expanded on a 2002 'Knowledge Inventory' at Partners to evaluate feasibility of designing a single representation approach entailing: (a) exploration of specific needs of different applications, in terms of kinds of response required (synchronous/asynchronous, time criticality, etc.), context (e.g., implied patient, time frame, or episode), and kinds of actions to be triggered; (b) kind of representation of knowledge and feasibility of casting knowledge in the form of if then statements; and (c) data and knowledge resources used (implied data model, and particular knowledge sources and terminology sources). The result of analysis was to design an architecture to accomplish this goal. We also did preliminary analysis of requirements for authoring for such a representation, and for implementation.