CAPABILITIES

AND

EXPERTISE

Use Case

Scenarios

FHIR/CDS Hooks

Solution for Zika

Screening

Proprietary Information

Zika Virus Screening The ability to quickly address, mitigate and report the spread of emerging clinical hazards using clinical

decision support is essential to ensure providers and patients have useful and appropriate information in a timely fashion

Such an "all hazards approach" must identify appropriate triggers, consume demographic data, assess presence or absence of symptoms, and determine timing of exposure to recommend appropriate testing and treatment

In 2016, Zika virus was an evolving global outbreak requiring new information to be accessed and consumed frequently for evaluation to ensure proper clinical decisions, guidance and recommendations

Our solution assesses Zika virus exposure and risk for pregnant women and their developing children

Utilizes EMR data as inputs to trigger clinical workflows and questionnaire

In our scenario, a patient presents at the point-of-care, and if the patient is a woman of child-bearing age, an app link card is presented via CDS Hooks

Our SMART-on-FHIR app evaluates risk of Zika infection through a series of clinically relevant questions

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Proprietary Information

Invokes CDS Hooks services1 to evaluate a patient for risk of Zika infection based on patient demographics and exposure, in accordance with Centers for Disease Control guidance

Seamlessly pulls relevant information directly from the patient's medical record for evaluation within our embedded rules engine

Responses provide additional context related to Zika exposure to determine next steps

Persists CDS Hooks cards on subsequent patient-views until new information becomes available

While working in the EMR, a clinician can perform multiple workflows in parallel, thereby achieving greater efficiency and information availability

Our solution provides bi-directional EMR integration, data exchange, workflow automation and interoperability with multiple EMR vendors

Our video demo is available here: https://youtu.be/KKnljbpuWUw

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1http://cds-hooks.org/

CDS Hooks Zika Solution

Proprietary Information19

Our CDS Hooks Implementation

{"id": “prime-dimensions-zika",

"url": "http://zika-test-app.herokuapp.com/cds-services/prime-dimensions-zika",

"name": “Prime Dimensions Zika",

"hook": "patient-view",

"prefetch": {

"myPatient": "Patient/{{Patient.id}}“},"enabled": true}

def cds_service():

print('CDS SERVICE REQUESTED')

@@ -110,14 +237,34 @@ def zika_launch():

{ "resourceType" : "Patient",

if patient['gender'] == 'female' and 14 <age < 49:

print("Woman of childbearing age.")

+ # Attempt to get the patient's local history

+ # record = db.session.query(Patient)

+ record =Patient.query.filter_by(patientId=patient['id']).first()

target_age_card['links'].append(link('Launch Tool', 'http://zika-test-app.herokuapp.com/cds-services/prime-dimensions-zika/' +patient['id']))cards_to_return.append(target_age_card)

{"resourceType" : "Questionnaire",

zika_travel_last_6_mos = RadioField('Patient has travelled to a Zika risk area

in the last 6 months:',[DataRequired()], choices=[('yes',

'Yes'), ('no', 'No')]

1. Invoke CDS services upon request for patient’s record (triggering event)

2. Determine if patient is female and of child-bearing age

3. Present CDS Hooks app link card

4. Initiate questionnaire

CDS Hooks is designed to help clinicians seamlessly invoke the proper clinical app(s) in real-time and provide information within context of the EMR

CDS Hooks are external services that are triggered by pre-defined events associated with clinical workflow patterns and patient data

Data is consumed via FHIR REST API and bound by a common hookInstance

For privacy and security, OAuth2 authorization provides access to the EHR’s FHIR server

Proprietary Information20

Interoperability with Leading EMR Vendors1

1As demonstrated at Connectathon 13 (https://speakerdeck.com/kpshek/cds-hooks-connectathon-sept-2016-summary)

Proprietary Information

Our Value-added FHIR Services• Implement complex clinical workflows and execute transactions and rules within FHIR resource

• SMART-on-FHIR application development

• Develop Design Specifications and Concept of Operations for proposed enterprise-wide FHIR solutions, including system interfaces, API management tools and data virtualization

• Offer expertise and competencies related to defining, implementing and registering FHIR Extensions

• Establish best practices for mapping FHIR to previous HL7 implementations

• Develop context diagrams, functional decompositions and data flow diagrams to define re-usable process definitions for redesigning, optimizing and automating clinical workflows that will be mapped to FHIR resources and profiles

• Serve as the systems integrator for the development and deployment of solutions that accelerate and/or complement FHIR adoption, such as data integration tools, analytics platform, workflow automation and visualization tools

• Develop an Enterprise data strategy that identifies common data structures and environments to streamline FHIR-enabled application development and encourage innovation

• Create, update and maintain APIs and FHIR-related documentation, process definitions and data models in a centralized knowledge base for all related artifacts

• Conduct facilitated sessions and interviews with business users, clinical users and technical staff to guide the development of compelling use cases for FHIR applications

Proprietary Information

Suman Sampath

Vice President, Client Solutions

301.728.6689

ssampath@primedimensions.com

Michael Joseph

Founder & CEO

703.861.9897

mjoseph@primedimensions.com

www.primedimensions.com

@PrimeDimensions

www.visolyr.io

Noah Hoskins, MD

Clinical Advisor

202.630.8042

nhoskins@primedimensions.com