Medical decision support via the internet: PROforma and Solo.

This paper describes the development and application of an integrated technology to support the authoring of intelligent medical knowledge services, such as decision and guideline support, and disseminate them over the Internet. Decision support and guideline enactment are provided by the PROforma technology which is described in detail elsewhere. Solo is a communications infrastructure that supports the delivery of PROforma services over the Internet using a web browser. The PROforma-Solo technology brings together techniques from knowledge engineering and artificial intelligence with software engineering and the Internet to flexibly support decision making and patient management at the point of care. A variety of clinical applications have been implemented and are briefly described.

Publets: clinical judgement on the web.

The Internet is now a major channel for publishing medical research data and documents, including clinical practice guidelines. It is now possible to capture guidelines in a computer interpretable form opening up the capability of using the internet (and intra/extranets etc.) to deliver patient-specific advice and other services. A development lifecycle and technology for publishing and delivering services at the point of care ("publets") are described. As with all new technologies, however, these new methods entail risks as well as opportunities. The paper closes with a discussion of quality requirements and an argument that publets should include a safety case as an integral part of their content.