ideasIdea
Living guidelines published as versioned, computable rules
Cancer treatment guidelines would be updated continuously and published in a form computers can read, so hospital systems, apps and decision tools update themselves the day the evidence changes.
Guidelines are PDFs updated annually or less; software that encodes them lags further. The proposal is for major guideline bodies (NCCN, ESMO, ASCO, national bodies) to publish recommendations as structured, versioned data (HL7 Clinical Practice Guidelines on FHIR, with explicit population, intervention, evidence grade and citation), updated within weeks of practice-changing evidence, with a public change log. The Australian living stroke and COVID guidelines and MAGICapp show living, structured guidance is feasible.
Hypothesis
Computable living guidelines will cut the median time from practice-changing publication to updated recommendation from more than a year to under 60 days, and downstream decision support will update within a further 30 days.
Rationale
Living guidelines have been maintained for stroke and COVID-19 for years; the machine-readable layer is what allows the update to propagate to the point of care rather than stopping at a website.
What would test it
One guideline body publishes one disease (for example metastatic NSCLC) as computable living guidance for two years; measure update latency and the number of software systems consuming the feed.
Maturity
early clinical
Who has to act
policy
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
- Knowledge reaches practice too slowly · Knowledge diffusion is slow: it takes years for a proven result to change what most patients receive, and no one can keep up with the literature.
fronts
1institutions
3ideas
8A plain-language explainer for every guideline recommendation, in every major languageA public API serving the current standard of care for any cancer, stage and biomarkerAutomatic flagging of retracted or corrected evidence in guidelines and decision supportDecision support that cites the exact trial and guideline line it relies onExpert-verified translation of guideline updates into 20 languages within 30 daysReal-time guideline-concordance feedback for every cancer centreSubscribable alerts when the standard of care changes for a patient's situationUpdate hospital order sets within 30 days of a guideline change