Sharing MLM's: an experiment between Columbia-Presbyterian and LDS Hospital

Abstract

The use of Arden syntax for development of shareable medical logic modules (MLM's) has developed as an ASTM standard. To test the feasibility of sharing MLM's between institutions a study was conducted between Columbia-Presbyterian Medical Center and LDS Hospital. In this study seven MLM's clinically executing at Columbia-Presbyterian were used to test the sharing potential of the Arden syntax. The study was limited to measuring the modifications necessary to make executable at LDS Hospital the shared MLM's. Because of the site specific nature of the data variables, multiple modifications were required. Three classes of modifications were necessary. The simplest involved only data variable mappings. The other classes required either minor modifications to the logic or relatively major modifications. Over 50% of the modifications were in the minor or major classes. While the sharing of decision logic was possible and facilitated by the use of the MLM's at the two sites, the absence of standard medical vocabularies limited the utility of the MLM as a mechanism for directly sharing medical knowledge.