BACKGROUND: The evolving science of evidence-based guideline development contributes to improved methodological rigor, transparency, and reliability. The Institute of Medicine (IOM) reports set standards establishing scientific credibility in the US and beyond for trustworthy guidelines and for systematic reviews. This was followed by several international efforts, including the Guidelines International Network. Among the many challenges imposed, the most daunting were the systematic reviews and keeping guidelines updated. In traditional approaches, each update was actually a de novoexercise since original extractions were painstaking, manual spreadsheet entries. Decisions about grouping terms and characteristics, selecting research arms and time points for analyses, and other such choices left traditional reviews without sufficient transparency and incapable of being updated. APPROACH: Today’s technologies provide the solutions with high quality, transparent, and methodologically rigorous evidence reviews. Digitizing the data from the screened studies permits direct and indirect meta-analyses, subgroup, and sensitivity analyses with greater efficiency and precision than traditional methods. Bodies of evidence can be easily visualized to demonstrate the frequency or level of heterogeneity on selected patient or intervention characteristics or outcomes. Importantly, new data can be pooled with an existing dataset as new research is published to keep the evidence current. PRACTICAL IMPLICATIONS: The capacity to monitor the literature for new studies that meet the pre-defined elements and inclusion criteria for a clinical guideline enhances the ability to build onto existing datasets as new research is published. Pooling newly digitized data with existing digital assets will then quickly allow the same analyses to be run to determine whether and how the new data will impact the strength or direction of the existing recommendations. This ability removes the traditional limitations and promotes living guidelines. CONCLUSIONS: With these technologies, guideline developers can meet the standards of today, produce more and better guidelines, and keep them living.