OpenClinical.net: Artificial intelligence and knowledge engineering at the point of care.

Abstract

OpenClinical.net is a way of disseminating clinical guidelines to improve quality of care whose distinctive feature is to combine the benefits of clinical guidelines and other human-readable material with the power of artificial intelligence to give patient-specific recommendations. A key objective is to empower healthcare professionals to author, share, critique, trial and revise these 'executable' models of best practice. OpenClinical.net <i>Alpha</i> (www.openclinical.net) is an operational publishing platform that uses a class of artificial intelligence techniques called <i>knowledge engineering</i> to capture human expertise in decision-making, care planning and other cognitive skills in an intuitive but formal language called PRO<i>forma</i>.3 PRO<i>forma</i> models can be executed by a computer to yield patient-specific recommendations, explain the reasons and provide supporting evidence on demand. PRO<i>forma</i> has been validated in a wide range of applications in diverse clinical settings and specialties, with trials published in high impact peer-reviewed journals. Trials have included patient workup and risk assessment; decision support (eg, diagnosis, test and treatment selection, prescribing); adaptive care pathways and care planning. The OpenClinical software platform presently supports authoring, testing, sharing and maintenance. OpenClinical's open-access, open-source repository <i>Repertoire</i> currently carries approximately 50+ diverse examples (https://openclinical.net/index.php?id=69). OpenClinical.net is a showcase for a PRO<i>forma</i>-based approach to improving care quality, safety, efficiency and better patient experience in many kinds of routine clinical practice. This human-centred approach to artificial intelligence will help to ensure that it is developed and used responsibly and in ways that are consistent with professional priorities and public expectations.