Manual

Manual implementation involves development of clinical guideline functionality using the computer interpretable (L3) content as a set of rigorously specified requirements for the implementation. In the absence of (L3) content, this is the only method.

Automatic

Automatic implementation involves programmatic translation of the L3 content into an appropriate L4 format. For example, a CQL query may be translated into an equivalent SQL query for execution, or a PlanDefinition may be transformed into a production rule, or the CQL may be interpreted directly into an execution environment. This approach involves potentially significant effort to build the appropriate tooling, but can pay dividends at scale once the tooling is in place.