Executing clinical practice guidelines using the SAGE execution engine

We report the first successful test of an interoperable guideline execution engine that interprets encoded clinical guideline content and executes that content via functions of a target clinical information system (CIS). For this test, an exemplar immunization guideline was encoded in the SAGE guideline model using standards-based information models and terminologies. This guideline content was subsequently executed using the prototype SAGE guideline execution engine, which interacts through standards-based VMR/Action services to instantiate real-time guideline recommendations via existing functions of the target CIS. In this paper, we describe our test implementation and highlight the significance and implications of each component of our deployment architecture.