The SAGE Project: A Universal Framework for Sharing Health Knowledge in the Form of Computable Clinical Practice Guidelines

The SAGE Project is a multi-institution effort to enable encoding and dissemination of interoperable, computable clinical practice guidelines. We have developed a standards-based guideline-knowledge representation model that specifies computable guideline content. We incorporate a “virtual medical record” that mediates both the encoding of guideline knowledge and the subsequent mapping to idiosyncratic CIS information environments. We employ a “workflow aware” approach to facilitative interaction between guideline-driven decision support and the host CIS. We have developed a guideline execution technology that interprets encoded guideline content; activates guideline logic in response to appropriate clinical events; retrieves patient data from the electronic medical record; makes patient-specific recommendations based on guideline logic; and surfaces guideline-driven decision support via actions of the host CIS. In results to date, we have encoded and deployed exemplar guidelines covering a range of clinical domains, including acute and chronic care, multi-disciplinary care settings; and population-based guideline logic.