Developing an architecture of a knowledge-based electronic patient record

Medicine as knowledge-intensive domain has been the subject of various approaches of computer-based knowledge management. Most of them concentrated on the design and implementation of expert systems for clinical decision support. Today, medical knowledge bases are implemented for various purposes, including encyclopedic sources of information for clinicians. We present a prototypical development of architecture for an electronic patient record which structurally depends on such an encyclopedic representation and is therefore knowledge-based. Using the KADS approach for knowledge engineering, three modeling steps and architectural parts could be identified, definition of basic concepts, the structural knowledge base model, and the interactive process of knowledge instantiation which constitutes clinical documentation. Furthermore, we present an analysis of possible benefits of a knowledge-based electronic patient record in health care as well as in adjacent fields.