Meta-architecture for the interoperability and knowledge management of archetype-based clinical decision support systems

Clinical Decision Support Systems (CDSS) are software applications that support clinicians in making health care decisions for individual patients. Such systems have been shown to improve care delivery and reduce costs. However, the lack of integration with Electronic Health Record systems and their high cost of maintenance have been identified as important barriers to their adoption. This paper aims, first, to describe a meta-architecture to seamlessly interoperate non-rule-based CDSS with archetype-based Electronic Health Records and, second, to allow the CDSS to perform self-maintenance tasks over its knowledge and inference engine. To achieve these objectives the Dual-Model Approach, in combination with clinical terminologies have been used to define a system capable to be plugged into any OpenEHR system and maintain its knowledge by using the semantics described through clinical terminologies.