Clinical Practice Guidelines as a JSON Service: A Proposed Architecture for Decision Support in Major Burning Management

Abstract

Clinical Practice Guidelines (CPGs) encode evidence-based clinical knowledge but are primarily distributed as unstructured PDF documents, making them inaccessible to automated clinical decision support (CDS) systems. This paper proposes a service-oriented architecture that formalizes the IMSS Clinical Practice Guideline for Major Burn Management (IMSS-375) as a versioned REST/JSON microservice. Seven clinical decision endpoints are defined, each encapsulating a specific GPC recommendation: burn classification, initial assessment, fluid resuscitation, pain management, infection prevention, nutritional support, and transfer criteria, following HL7 FHIR R4 interoperability standards. A mapping between GPC clinical rules (including the Parkland formula, Benaim scale, Curreri formula, and Baux prognostic index) and structured JSON request/response schemas is presented and evaluated against related formalization approaches and verified through structured schema-level invocations against a representative clinical scenario, including a detailed comparison of Mexico IMSS-375 standard properties against HL7 FHIR and OpenEHR. A deployment architecture is described covering hospital-level integration, a centralized service layer, and a non-relational persistence tier based on document-oriented storage for unstructured clinical data.