Our initial aim was to develop a 4-stage model for CDS rule refinement, and based on this model, create and evaluate an Implementer’s Workbench (IW) for CDS knowledge formalization, adaptation, and implementation. A particular emphasis was on Setting-Specific Factors (SSFs) such as local workflow, practice patterns, site characteristics, users, EHR platform, and application and rule deployment functionality. The project required definition of knowledge representation, user interface, and taxonomy of SSFs to be used, and development of initial set of knowledge content for deployment in the area of diabetes management.
A revised goal is to work with the ONC’s Standards and Interoperability Framework’s Health e-Decisions Initiative (HeDI), to help devise a nationally adopted representation of knowledge that can be incorporated broadly by vendors and producers of EHRs into their systems. Our original intent was to work with selected vendors to show feasibility of our approach, but we believe that this work will have greater impact if it is aligned with the HeDI to influence the way all producers of knowledge content and vendors and producers of EHRs expect to receive knowledge content for execution in their systems.