Guidelines Into Decision Support (GLIDES)

The GLIDES project (GuideLines Into Decision Support) was a collaborative effort to design, develop, implement, and demonstrate clinical decision support (CDS) applications using systematic and replicable processes for knowledge transformation and CDS design. CDS incorporates a broad and complex array of activities, from the development of clinical guidelines and policy statements to the design, development, and deployment of machine-executable advice. The goal of the project was to capture high-quality knowledge about appropriate care (knowledge synthesis), transform it into a standard format that facilitates computer execution (knowledge formalization), and embed the formalized knowledge in systems that actually influence care (knowledge localization).

The objectives of the project were to:

• Implement evidence-based guideline recommendations that address prevention of pediatric obesity and chronic management of asthma.  
• Apply the Guideline Elements Model (GEM) and associated tools that facilitate the development of executable code to systematically and replicably transform the knowledge contained in these guidelines into a computable format. 
• Deliver the knowledge via CDS to ambulatory sites that employ the Centricity electronic health record (EHR) at Yale and EpicCare EHR at Nemours. 
• Evaluate the fulfillment of these goals and the effectiveness of the decision support tools in improving the quality of health care. 
• Disseminate the findings and lessons learned via a variety of modalities. 

GLIDES pursued opportunities to improve CDS practices, creating and demonstrating software tools, methodologies, and recommendations for future practice. A centerpiece of the GLIDES strategy was the GEM. The GEM Suite comprises a knowledge model and a collection of software tools that facilitate development, dissemination, and implementation of clinical practice guidelines and other sources of evidence-based knowledge. 

GLIDES involved a group of insightful and committed partners, promoted multilateral interactions among the collaborators, and advanced the science of decision support. However, at the completion of the project, the team recognized that gaps persist. Standards for development of trustworthy guidelines have not been universally adopted; criteria for judging adherence to the standards have yet to be developed; standards for knowledge formalization and acceptance by academics, information technology professionals, and vendors have not occurred. However, GLIDES has significantly contributed to the development and dissemination of systematic and replicable processes for knowledge localization.