medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms

Abstract Background Sub-optimal healthcare quality in low-resource settings is attributed in part to poor adherence to clinical guidelines. Clinical decision support systems (CDSS) help to integrate guideline-based algorithms into logical workflows and improve adherence to evidence-based recommendat...

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Main Authors: Ludovico Gennaro Cobuccio, Vincent Faivre, Rainer Tan, Alan Vonlanthen, Fenella Beynon, Emmanuel Barchichat, Alain Fresco, Quentin Girard, Sinan Ucak, Sylvain Schaufelberger, Ibrahim Evans Mtebene, Peter Agrea, Emmanuel Kalisa, Gillian A. Levine, Martin Norris, Sabine Renggli, Alix Miauton, Lisa Cleveley, Kristina Keitel, Julien Thabard, Valérie D’Acremont, Alexandra V. Kulinkina
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-03077-6
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author Ludovico Gennaro Cobuccio
Vincent Faivre
Rainer Tan
Alan Vonlanthen
Fenella Beynon
Emmanuel Barchichat
Alain Fresco
Quentin Girard
Sinan Ucak
Sylvain Schaufelberger
Ibrahim Evans Mtebene
Peter Agrea
Emmanuel Kalisa
Gillian A. Levine
Martin Norris
Sabine Renggli
Alix Miauton
Lisa Cleveley
Kristina Keitel
Julien Thabard
Valérie D’Acremont
Alexandra V. Kulinkina
author_facet Ludovico Gennaro Cobuccio
Vincent Faivre
Rainer Tan
Alan Vonlanthen
Fenella Beynon
Emmanuel Barchichat
Alain Fresco
Quentin Girard
Sinan Ucak
Sylvain Schaufelberger
Ibrahim Evans Mtebene
Peter Agrea
Emmanuel Kalisa
Gillian A. Levine
Martin Norris
Sabine Renggli
Alix Miauton
Lisa Cleveley
Kristina Keitel
Julien Thabard
Valérie D’Acremont
Alexandra V. Kulinkina
author_sort Ludovico Gennaro Cobuccio
collection DOAJ
description Abstract Background Sub-optimal healthcare quality in low-resource settings is attributed in part to poor adherence to clinical guidelines. Clinical decision support systems (CDSS) help to integrate guideline-based algorithms into logical workflows and improve adherence to evidence-based recommendations, and hence quality of care. However, the process of translating paper-based guidelines into electronic algorithmic formats is often complex, inefficient, expensive, and error-prone due to reliance on advanced software development skills and clinical knowledge. Methods In response to these challenges, we developed open-source software called the Medical Algorithm Suite (medAL-suite), consisting of four components, with a primary goal of increasing efficiency, accuracy, and transparency of CDSS creation by giving experienced clinicians, rather than software developers, greater control over the process. At the heart of the software suite is the medAL-creator that allows clinicians to design algorithms using a code-free drag-and-drop interface. Algorithms are subsequently automatically deployed in medAL-reader to service level clinicians in health facilities. CDSS implementers use medAL-data and medAL-hub to manage configuration, versioning, and deployment. Results Since its development, the medAL-suite has been used to digitalize complex primary care guidelines and deployed in large-scale clinical studies in Tanzania, Rwanda, Kenya, Senegal, and India, leading to notable outcomes such as the reduction of inappropriate antibiotic prescriptions and improvement in care quality. Over 300,000 pediatric outpatient consultations have been completed in Rwanda and Tanzania to date using the digital algorithm. Discussion The medAL-suite focused on democratized development, process-centric design, point-of-care utility, touch-screen interface, low cost, and low power consumption to contribute to sustainable digital systems in low-resource settings. Important future developments and adaptations as the software evolves should emphasize interoperability and scalability, primarily via integrating CDSS functionality into electronic medical records for a streamlined user experience that supports improved service quality at the point-of-care. Clinical trial number Not applicable.
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institution Kabale University
issn 1472-6947
language English
publishDate 2025-07-01
publisher BMC
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series BMC Medical Informatics and Decision Making
spelling doaj-art-dfa474081d3a47b3b56364fd1d7068b22025-08-20T03:45:30ZengBMCBMC Medical Informatics and Decision Making1472-69472025-07-0125111210.1186/s12911-025-03077-6medAL-suite: A software solution for creating and deploying complex clinical decision support algorithmsLudovico Gennaro Cobuccio0Vincent Faivre1Rainer Tan2Alan Vonlanthen3Fenella Beynon4Emmanuel Barchichat5Alain Fresco6Quentin Girard7Sinan Ucak8Sylvain Schaufelberger9Ibrahim Evans Mtebene10Peter Agrea11Emmanuel Kalisa12Gillian A. Levine13Martin Norris14Sabine Renggli15Alix Miauton16Lisa Cleveley17Kristina Keitel18Julien Thabard19Valérie D’Acremont20Alexandra V. Kulinkina21Centre for Primary Care and Public Health (Unisanté), University of LausanneCentre for Primary Care and Public Health (Unisanté), University of LausanneCentre for Primary Care and Public Health (Unisanté), University of LausanneCentre for Primary Care and Public Health (Unisanté), University of LausanneSwiss Tropical and Public Health InstituteWavemindWavemindWavemindWavemindCentre for Primary Care and Public Health (Unisanté), University of LausanneIfakara Health InstituteNational Institute for Medical Research, Mbeya Medical Research CenterSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteIfakara Health InstituteCentre for Primary Care and Public Health (Unisanté), University of LausanneSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteCentre for Primary Care and Public Health (Unisanté), University of LausanneCentre for Primary Care and Public Health (Unisanté), University of LausanneSwiss Tropical and Public Health InstituteAbstract Background Sub-optimal healthcare quality in low-resource settings is attributed in part to poor adherence to clinical guidelines. Clinical decision support systems (CDSS) help to integrate guideline-based algorithms into logical workflows and improve adherence to evidence-based recommendations, and hence quality of care. However, the process of translating paper-based guidelines into electronic algorithmic formats is often complex, inefficient, expensive, and error-prone due to reliance on advanced software development skills and clinical knowledge. Methods In response to these challenges, we developed open-source software called the Medical Algorithm Suite (medAL-suite), consisting of four components, with a primary goal of increasing efficiency, accuracy, and transparency of CDSS creation by giving experienced clinicians, rather than software developers, greater control over the process. At the heart of the software suite is the medAL-creator that allows clinicians to design algorithms using a code-free drag-and-drop interface. Algorithms are subsequently automatically deployed in medAL-reader to service level clinicians in health facilities. CDSS implementers use medAL-data and medAL-hub to manage configuration, versioning, and deployment. Results Since its development, the medAL-suite has been used to digitalize complex primary care guidelines and deployed in large-scale clinical studies in Tanzania, Rwanda, Kenya, Senegal, and India, leading to notable outcomes such as the reduction of inappropriate antibiotic prescriptions and improvement in care quality. Over 300,000 pediatric outpatient consultations have been completed in Rwanda and Tanzania to date using the digital algorithm. Discussion The medAL-suite focused on democratized development, process-centric design, point-of-care utility, touch-screen interface, low cost, and low power consumption to contribute to sustainable digital systems in low-resource settings. Important future developments and adaptations as the software evolves should emphasize interoperability and scalability, primarily via integrating CDSS functionality into electronic medical records for a streamlined user experience that supports improved service quality at the point-of-care. Clinical trial number Not applicable.https://doi.org/10.1186/s12911-025-03077-6Clinical decision supportAlgorithmDigital healthClinical guidelinesCDSS
spellingShingle Ludovico Gennaro Cobuccio
Vincent Faivre
Rainer Tan
Alan Vonlanthen
Fenella Beynon
Emmanuel Barchichat
Alain Fresco
Quentin Girard
Sinan Ucak
Sylvain Schaufelberger
Ibrahim Evans Mtebene
Peter Agrea
Emmanuel Kalisa
Gillian A. Levine
Martin Norris
Sabine Renggli
Alix Miauton
Lisa Cleveley
Kristina Keitel
Julien Thabard
Valérie D’Acremont
Alexandra V. Kulinkina
medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
BMC Medical Informatics and Decision Making
Clinical decision support
Algorithm
Digital health
Clinical guidelines
CDSS
title medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
title_full medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
title_fullStr medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
title_full_unstemmed medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
title_short medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms
title_sort medal suite a software solution for creating and deploying complex clinical decision support algorithms
topic Clinical decision support
Algorithm
Digital health
Clinical guidelines
CDSS
url https://doi.org/10.1186/s12911-025-03077-6
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