Developing nursing computer interpretable guidelines: a feasibility study of heart failure guidelines in homecare

Abstract

Homecare is the fastest growing healthcare sector and evidence based information systems are critically needed. Nurses provide most of the care in homecare setting, yet there is a lack of knowledge on the feasibility of applying existing methodologies to generate computer interpretable nursing guidelines for home care. This study examined the feasibility of encoding homecare nursing heart failure guideline into a computer interpretable format. First, we achieved experts' consensus on the relevant guideline. Then, after training on the graphical tool for gradual knowledge specification (Gesher), we generated a comprehensive, hierarchical and time-oriented computer interpretable guideline using one of the guideline modeling languages (Asbru). The final guideline included 167 recommendations and experts' evaluation confirmed the adequacy of guideline knowledge representation. Future work should expand the applicability of our methodology and tools to nursing specialties other than heart failure and develop methods for comprehensive quality evaluation of the resulting guidelines.

Figures

Figure 1:

Semi-formal guideline specification using the “Hierarchical Plan Builder” interface.

Figure 2:

Guideline concepts specification using the “Knowledge Map” interface.

Figure 3:

Interface for interactive exploration of hierarchical diagrams of clinical guidelines