GLIF

1
GLIF GELLO Archetypes

• Jared Davison
• Medical-Objects
• Australia

2
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)

3
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

4
Key Points

• Contact with GELLO authors and researchers
• Raised issues for inclusion in second ballot of
  GELLO

5
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)
13
GELLO Compiler IDE
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Setting up SNOMED-CT Codes
15
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