Integrating medical information and knowledge in the HL7 RIM.

Guidelines have a proven ability to improve quality of health care and reduce cost, yet, guidelines are not very well deployed at the point of care. This is largely due to the impedance mismatch between decision support modules and the Electronic Medical Record (EMR.) The Unified Service Action Model (USAM) as part of the HL7's Reference Information Model provides a conceptual integration between patient data and medical knowledge. The USAM defines one action-oriented information structure for patient data, concept definitions, action plans, conditionals, and goals. This suggests a new approach to the problem of sharing data and knowledge, effectively working around the problem of missing domain terminology.