Design and implementation of the GLIF3 guideline execution engine

Dongwen Wang, Mor Peleg, Samson W. Tu, Aziz A. Boxwala, Omolola Ogunyemi, Qing Zeng, Robert A. Greenes, Vimla L. Patel, Edward H. Shortliffe

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


We have developed the GLIF3 Guideline Execution Engine (GLEE) as a tool for executing guidelines encoded in the GLIF3 format. In addition to serving as an interface to the GLIF3 guideline representation model to support the specified functions, GLEE provides defined interfaces to electronic medical records (EMRs) and other clinical applications to facilitate its integration with the clinical information system at a local institution. The execution model of GLEE takes the "system suggests, user controls" approach. A tracing system is used to record an individual patient's state when a guideline is applied to that patient. GLEE can also support an event-driven execution model once it is linked to the clinical event monitor in a local environment. Evaluation has shown that GLEE can be used effectively for proper execution of guidelines encoded in the GLIF3 format. When using it to execute each guideline in the evaluation, GLEE's performance duplicated that of the reference systems implementing the same guideline but taking different approaches. The execution flexibility and generality provided by GLEE, and its integration with a local environment, need to be further evaluated in clinical settings. Integration of GLEE with a specific event-monitoring and order-entry environment is the next step of our work to demonstrate its use for clinical decision support. Potential uses of GLEE also include quality assurance, guideline development, and medical education.

Original languageEnglish (US)
Pages (from-to)305-318
Number of pages14
JournalJournal of Biomedical Informatics
Issue number5
StatePublished - Oct 2004
Externally publishedYes


  • Clinical decision support systems
  • Clinical practice guidelines
  • Computer-assisted decision-making
  • Guideline execution engine
  • Health care quality assurance
  • Knowledge representation
  • Theoretical models

ASJC Scopus subject areas

  • Health Informatics
  • Computer Science Applications


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