The morningside initiative sharing of knowledge and methods for clinical decision support
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The Morningside Initiative: Sharing of Knowledge and Methods for Clinical Decision Support

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The Morningside Initiative:Sharing of Knowledge and Methods for Clinical Decision Support

American Medical Informatics Association; Arizona State University; Department of Defense Tri-Care Management Activity, Military Health System; Henry Ford Health System; Intermountain Healthcare; Kaiser Permanente; Partners Healthcare; Veterans Healthcare Administration


Knowledge Sources

Shared Knowledge Base

Goals and approaches

  • Overcome resistance to sharing clinical decision support (CDS) knowledge, methods, and experience among organizations

    • Establish feasibility with small group of committed and experienced participants

  • Develop an organizational framework for collaboration

    • Intent to become self-sustaining

  • Establish functional requirements for content and tools to foster interoperability

    • Address knowledge acquisition, representation/ markup, curation, and localization

    • Drive process with use cases requiring SOA-based implementation

  • Develop representations and tools to overcome technical barriers

    • Adopt standards and drive development of ones that are lacking to foster interoperability

    • Identify and separate medical vs. business logic and facilitate localization and adaptation

  • Content foci

    • Begin with implemented CDS knowledge content and reuse

      • Initially diabetes rules and order sets

      • Subsequent goal of assimilating best practice knowledge


  • Convening and organizational support by TATRC

  • AMIA to provide organizational home for public-private partnership during early stages


  • Steering Committee

    • Representatives of each organization

    • Processes and procedures for collaboration, pursuit of funding, growth of initiative, approach to long-term sustainability

  • Content Committee

    • Use-case driven focus on kinds of application needs, sources of knowledge, editing and approval process, application of knowledge

  • Technical Committee

    • Tools and resources to share, manage, represent, update knowledge

Functional requirements

  • Driving use cases: Interoperable delivery of CDS at point of care through SOA interface

    • DoD AHLTA and NHIN interoperability node as first case

      • Goal of establishing a Knowledge Management Repository (KMR) and Guideline Workbench

      • To deliver CDS into AHLTA environment via SOA

      • Show interoperability on the NHIN DoD Federal Adapter

  • Overall model has 4 components

    • Knowledge Repository – the content

      • Maintaining stages of analysis, provenance of content

      • Target of standard representation with annotations enabling localization and adaptation to particular settings

    • Tools for knowledge acquisition, markup, management, and localization - the technology

    • Methods, ontologies, and schemas for sharability

      • Meta data tags, standards, templates, and vocabularies for representation and markup

      • Taxonomy of process/workflow/implementation contexts

    • SOA-based delivery – the execution environment

      • Not the focus of Morningside but provide the driving use cases

Collaborative Knowledge Management

Enterprise Knowledge Base

Enterprise Knowledge Base

Enterprise Knowledge Base




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