Electronic health record to support Chronic Kidney Disease prevention — Integrating guidelines and archetypes

As Chronic Kidney Disease (CKD) incidence in the world is increasing, preventive actions are necessary. Integration of Clinical Practice Guidelines (CPG) into the Electronic Health Record (EHR) may facilitate prevention. Thereby identification of data described in CPGs and representation of these data into EHR, are difficulties to develop a guideline-based EHR for prevention. Archetypes allow representation of information contained in CPG, applying the same format across all EHR's modules. Therefore, the objective of this research was to develop an EHR including decision support structured in archetypes and based on CPG for CKD prevention. The EHR system developed follows five steps: identification of the data and the rules specified in the guideline; archetype elaboration; definition and inclusion of rules in a rule-based inference engine and elaboration of the DSS; DSS-EHR integration; and DSS validation. Eight archetypes and forty rules composes the resulting system.