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Proc AMIA Symp. 2001 : 204–208.
PMCID: PMC2243348

An implementation framework for GEM encoded guidelines.


Access to timely decision support information is critical for delivery of high-quality medical care. Transformation of clinical knowledge that is originally expressed in the form of a guideline to a computable format is one of the main obstacles to the integration of knowledge sharing functionality into computerized clinical systems. The Guideline Element Model (GEM) provides a methodology for such a transformation. Although the model has been used to store heterogeneous guideline knowledge, it is important to demonstrate that GEM markup facilitates guideline implementation. This report demonstrates the feasibility of implementation of GEM-encoded guideline recommendations using Apache Group s Cocoon Web Publishing Framework. We further demonstrate how XML-based programming allows for maintaining the separation of guideline content from processing logic and from presentation format. Finally, we analyze whether the guideline authors original intent has been sufficiently captured and conveyed to the end user.

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  • Ohno-Machado L, Gennari JH, Murphy SN, Jain NL, Tu SW, Oliver DE, Pattison-Gordon E, Greenes RA, Shortliffe EH, Barnett GO. The guideline interchange format: a model for representing guidelines. J Am Med Inform Assoc. 1998 Jul-Aug;5(4):357–372. [PMC free article] [PubMed]
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  • Shiffman RN, Karras BT, Agrawal A, Chen R, Marenco L, Nath S. GEM: a proposal for a more comprehensive guideline document model using XML. J Am Med Inform Assoc. 2000 Sep-Oct;7(5):488–498. [PMC free article] [PubMed]

Articles from Proceedings of the AMIA Symposium are provided here courtesy of American Medical Informatics Association