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The SAGE Guideline Model: Achievements and Overview

^a Department of Medicine, Stanford University School of Medicine, Stanford, CA
^b University of Nebraska Medical Center, Omaha, NE
^c GE Healthcare Integrated IT Solutions, Seattle, WA
^d Mayo Clinic, Rochester, MN
^e Apelon Inc., Ridgefield, CT
^f RemedyMD Inc., Sandy, UT
^g Hospira, Inc., Lake Forest, IL
^h Kea Analytics, Bothell, WA

^_* Correspondence and reprints: Samson W. Tu, MSOB X259, 251 Campus Drive, Stanford, CA 94305-5479 (Email: swt{at}stanford.edu).

Received for publication: 02/04/07; accepted for publication: 05/22/07.

The SAGE (Standards-Based Active Guideline Environment) project was formed to create a methodology and infrastructure required to demonstrate integration of decision-support technology for guideline-based care in commercial clinical information systems. This paper describes the development and innovative features of the SAGE Guideline Model and reports our experience encoding four guidelines. Innovations include methods for integrating guideline-based decision support with clinical workflow and employment of enterprise order sets. Using SAGE, a clinician informatician can encode computable guideline content as recommendation sets using only standard terminologies and standards-based patient information models. The SAGE Model supports encoding large portions of guideline knowledge as re-usable declarative evidence statements and supports querying external knowledge sources.