There is general recognition that the use of clinical test ordering protocols supported by Information Technology can enhance quality and proper usage of clinical laboratory resources. This effort aims at addressing the requirement for a generic framework and software environment for the specification, execution and management of clinical test ordering protocols. The approach taken for the representation of clinical test order protocols is based on the event-condition-action (ECA) rule paradigm as defined in active databases. In this paper, a relational database approach to maintaining the protocol specification is discussed. Emphasis is placed on the importance of the efficient and effective management of computer-based test ordering protocol specifications at both schema and instance levels. A framework for the execution and management of clinical test ordering protocols is presented. A distinction and separation is drawn between the static protocol (specification) and the dynamic patient test plan (protocol instance).