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GLIF – GELLO – Archetypes
Jared Davison
Medical-Objects
Australia
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Key Points• GLIF and GELLO implementation using
Lymphoma as the clinical example• Arden was considered but GELLO felt to be
better fit– GELLO was Object-Oriented– Interface with data model– vMR rather than use curly braces– Closely related to Object Constraint Language
(OCL)
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Key Points• GLIF chosen as guideline representation
language– Inspiration for GELLO– Specific lacking detail, specifically no
structures to accommodate GELLO
• GELLO specifications had not been implemented– Significant errors and lacked required features
• eg no standard way of passing parameters to GELLO and no formal definitions of GELLO libraries
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Key Points• Contact with GELLO authors and
researchers– Raised issues for inclusion in second ballot of
GELLO
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Key Points• GELLO requires a VMR for access to patient
data– Lack of specifications for vMR– Created abstraction of HL7 v2 model– Could be represented as v3
• Used Archetype Definition Language (ADL) to define data structures for user data-entry– Encoded in HL7 v2 OBX using an experimental
technique– Enables re-use and re-editing of data– Also used for decision support
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GLIF Guideline - Lymphoma
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Archetype Editor with GELLO Events
GELLO Expressions
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Lymphoma Archetype Example
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Completed Archetype Example
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Editing Lymphoma Type Codes
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Editing Help Text (Didactics)
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Editing Decision Logic (GELLO)
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GELLO Compiler IDE
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Setting up SNOMED-CT Codes
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Lymphoma Scenario
Jack Smith age 63, 5 visits/episodes in all for treatment cycles including registration and early data gathering *2 visits, Diffuse large B-cell lymphoma, increased FLIPI, responds to treatment, bulky stage II, work to guidelines, radiotherapy gets a letter, pathology radiology requests and reports, Rx rituximab, CHOP and radiotherapy, and ABCR notifications
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Patient Registration
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GLIF Guideline Execution
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GLIF Guideline Execution
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Record Reported Symptoms
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Ordering Blood Tests
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Clinical Staging Data
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Patient Data Summary
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Curative Intent Treatment Plan
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Example of Supporting Evidence
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Cancer Registry Notification