Architectural design of a clinical decision support system for clinical triage in emergency departments: Analysis of performance, availability and security

Abstract

Clinical triage is a key process in emergency departments because it allows clinicians to prioritize patient treatments based on their health condition. Handling this process adequately will allow those departments to operate efficiently. Most of its concerns are related to its effectiveness due to the short timeframes that clinical staff have during the process and the lack of valuable, timely and pertinent information available. In several contexts, this problem has been addressed by using clinical decision support systems. However, there is not enough information about architectural approaches dealing with key quality attributes and restrictions involved in those systems. This paper aims to analyze and discuss a feasible architectural approach to implement a clinical decision support system for clinical triage by adapting proposals from other scenarios. As main contribution, this proposal describes the architecture design process applied through a well-known standard and emphasizes tactics for performance, availability and security. For this purpose, an attribute-driven design method was followed, concluding that it is a convenient approach because it allows to iterate easily the entire system by prioritizing key elements. The achieved results are useful for architects, implementers, practitioners and researchers to extend the architecture and apply it.