OpenClinical: Prestige

Clinical demonstrators

Methods and tools for the development of computer-interpretable guidelines

Prestige Conceptual Guideline Model

The Prestige project was focused on the application of telematics technologies to support the dissemination and implementation of clinical practice guidelines and protocols.

keywords	Conceptual guideline model, computer-interpretable guidelines, guideline authoring, guideline enactment
developed by	The Prestige project
introduced	1996
status	Discontinued. Project funding concluded in 1999.
support	EU 4th Framework Health Telematics programme
in use	N/A
tools	N/A

description

The Prestige Conceptual Guideline Model describes the kind of information - the concepts and the relationships between them - needed to support the use of guidelines in the planning and provision of personal healthcare. This implies a wide-ranging ability to represent knowledge about medicine, patients and carers, and the enterprises and personnel that care for them. It has proved possible to produce such a model that is portable, i.e. is applicable in any organisation using any technology.
It provides an essential part of a meta-language for those responsible for writing the generic clinical scripts for particular scenarios, the protocol authors.

Part of the Prestige guideline model: component states

The Model has two major subdivisions. The first describes healthcare in general, and the second focuses on clinical protocols. The Model has been built and stored using a proprietary object-oriented CASE tool, SELECT Enterprise, which can produce skeleton software if required.
Two guideline authoring tools have been built:

GAUDI (GUideline Authoring and Dissemination Tool), illustrated below, which incorporates a terminology server and model (GRAIL, developed by GALEN);
GLEAM (GuideLine Editing and Authoring Module), which supports direct editing of an application knowledge base.

GAUDI guideline authoring tool - Click on the screen to view full size image

Click on the screen to view full size image
Prestige clinical application: Assistance for medication planning using a guideline for the management of stable angina.

references

C Gordon, I Herbert, P Johnson, P Nicklin, P Reeves. Telematics for Clinical Guidelines: A Conceptual Modelling Approach. Proceedings of MIE'97.

[Full paper]

" PRESTIGE is a project for applying telematics to assist the dissemination and application of clinical practice guidelines and protocols. Previous publications have described PRESTIGE’s technical approach, including the use of a generic model for representing the knowledge content of clinical guidelines. [1,2,3] This approach offers the possibility of ‘plug-and-play’ electronic distribution of clinical guidelines produced by multiple authoring bodies for use on multiple healthcare clinical management software platforms. A recent joint workshop held with the Section on Medical Informatics, Stanford University School of Medicine compared the European consensus approach developed in PRESTIGE with a parallel series of projects for computer-assisted protocol-based healthcare undertaken at Stanford and other American centres over the past, which confirmed the convergence and complementarity of our approaches, and holds out prospects of world-wide standardization in healthcare protocol knowledge representation. In this paper we summarise the PRESTIGE conceptual model set which is the design foundation of our approach. "

C Gordon, M Veloso et al. Guidelines in Healthcare: the experience of the Prestige project. Proceedings of MIE'99.

[Full paper]

" PRESTIGE: Guidelines in Healthcare [a project in the EC's Telematics Application Programme (DG XIII C4), December 1995-May 1999] is one of the most extensive initiatives yet undertaken worldwide to apply information and communication technology to assist healthcare professionals in the daily application of evidencebased guidelines of best practice. The project has been a collaboration of 30 organizations from eight countries, representing all the key players whose contribution is essential to this initiative: national and international bodies which are authors of standard clinical guidelines, health authorities, associations of clinical professionals, commercial system suppliers in primary and secondary care, academic centres, hospitals and health centres. The project has created clinical applications in six countries, linked to established clinical IT environments, with programmes for validation in routine practice. The aim of the project is "an installed and sustainable healthcare telematics infrastructure that supports dissemination and application of research based and consensus based guidelines, that in turn supports best practice for routine clinical care". "

contact	Dr. Luis Mario Veloso Hospital de Egas Moniz Rua Da Junqueira, 126 P-1300 Lisboa Portugal
links	Prestige (EHTO) Prestige (University of Mainz) HTML version of the Desktop Guide for the management of Non-insulin-dependent Diabetes Mellitus (from the European NIDDM policy group)

acknowledgements

Material on this page has been edited from documents supplied by the Prestige project (1996-1999).

page history

Entry on OpenClinical: 2001
Last main update: 2002.
Content archived 2002.

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