Why do you think this paper is highly cited?

I believe the paper is highly cited because it was the first to describe a consensus-based modeling strategy for clinical guidelines and other activities based on medical logic, based on the experiences of several institutions. Clinical guidelines are considered to be very important to enhance current health care, by decreasing practice variation and improving patient outcomes. The process of automating clinical guidelines is complex and this article describes a knowledge representation model to facilitate the interchange of information among different institutions, and eventually facilitate the implementation of such guidelines in computer systems.

  Does it describe a new discovery or new methodology that's useful to others?

The paper describes an object-oriented model that can potentially be implemented by other researchers, in a variety of medical domains. Although the paper summarizes previous literature on the subject, its main contribution is to publish the first version of a consensus-based, institution-independent model to represent clinical guidelines.

  Can you summarize the significance of your paper in laymen's terms?

This research is significant because it provides a common "language" for computer scientists and health care professionals to represent and interchange clinical guidelines.