Abstract: A clinical practice guideline can be implemented using a guideline execution engine. The engine can interpret the clinical practice guideline, obtain medical data stored in a clinical information system (CIS), and implement an action in response to execution of the clinical practice guideline based on medical data for a patient obtained from the CIS. The use of the CIS medical data in guideline execution beneficially allows the guideline to be tightly integrated into the real-time workflow of a clinician in a clinical setting and to provide patient-specific guideline recommendations. A VMR/actions interface facilitates communications between a guideline execution system and a CIS by processing a request for medical data from the guideline execution engine and implementing actions on the CIS requested by the guideline execution engine.