Ongoing/Planned Activities for Week of 4/29
description
Transcript of Ongoing/Planned Activities for Week of 4/29
Ongoing/Planned Activities for Week of 4/29
• Final UCR Crosswalk due COB 4/30 • Hold two working sessions to complete UCR Crosswalk on 4/30• Hold working session at the Standards SWG on 5/1 to discuss results of the UCR
Crosswalk using summary slides, and choose Standards to move forward with• Present Results of UCR Crosswalk All Hands meeting on 5/2• Our concentration is the Service/Payloads Standards; transport/security and
vocab and code set are secondary discussions
• Discuss selection of standards on 5/1 SWG call and continue conversation/selection during 5/2 WG
• Gap Mitigation Plan will be developed out of the UCR Crosswalk and initial draft will be due COB 5/7
• Solution Diagram has been updated with suggested changes. Will review with the community at the All Hands Call on 5/2, and will update with the Selected Standards
• Populating Data Requirements Table Internally.
Use Case 2 – CDS Guidance Service Transactions
CDS Guidance Requestor
2. CDS Response(Clinical Data, Supporting Evidence, Supporting
Reference, Actions, Attribute-Value List, Response Metadata & Exceptions)
CDS Guidance Supplier
1. CDS Request (Clinical Data & Context)
INSERT SELECTED STANDARDS HERE
INSERT SELECTED STANDARDS HERE
Transport and Security
Transactional Layers
3
Transport and SecurityResponse Service: e.g., DSS Response ElementResponse Items Organizer/Container: e.g., HeD Action Groups Element
Response Item Payload: e.g., VMR Proposal
Request Service: e.g., DSS Request ElementRequest Items Organizer/Container: e.g: VMR or CCDA
Request Item Payload: e.g., VMR Clinical Statement
Use Case 2: CDS Guidance Service Transactions - Standards per Transaction
# Transaction Service Organizer/Container Item PayloadsReference
Information Model
1CDS Request (patient data
and potentially context)
• Decision Support Service (DSS)
• Context Aware Retrieval Application (Infobutton)
• CDS Knowledge Artifact Implementation Guide (HeD UC1 IG)
• Consolidated CDA• Virtual Medical Record
(vMR)
• Context Aware Retrieval Application (Infobutton)
• Virtual Medical Record (vMR)• Consolidated CDA (hL7 Clinical
Statements)• HL7 Version 3 Standard: Order Set
Publication, Release 1
• Federal Health Information Model (FHIM)
• HL7 v2.x• HL7 v3
2 CDS Response (guidance
and/or other response elements)
• Decision Support Service (DSS)
• Context Aware Retrieval Application (Infobutton)
• CDS Knowledge Artifact Implementation Guide (HeD UC1 IG)
• HL7 Version 3 Standard: Order Set Publication, Release 1
• Consolidated CDA• Virtual Medical Record
(vMR)
• Context Aware Retrieval Application (Infobutton)
• Virtual Medical Record (vMR)• Consolidated CDA (HL7 Clinical
Statements)• HL7 Version 3 Standard: Order Set
Publication, Release 1
• Federal Health Information Model (FHIM)
• HL7 v2.x • HL7 v3
Use Case 2: CDS Guidance Service Transactions - Standards per Transaction
# Transaction Transport Authentication/Authorization Encryption Vocab & Code Set
1CDS Request (patient data
and potentially context)
• SOAP• REST
• SAML • TLS • LOINC• SNOMED CT• CVX• Manufacturers of Vaccines (MVX)• OID• RxNorm• ICD-9-CM and ICD-10-CM• HCPCS• C80 - Clinical Document and
Message Terminology Component • NQF Value Sets
• ICD-10-PCS• UCUM• CPT• C154• NDC• FDA Route Administration• HL7 Vocabulary• Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition (DSM-IV)
2 CDS Response (guidance
and/or other response elements)
• SOAP • REST
• SAML • TLS • LOINC• SNOMED CT• CVX• Manufacturers of Vaccines (MVX)• OID• RxNorm• ICD-9-CM and ICD-10-CM• HCPCS• C80 - Clinical Document and
Message Terminology Component • NQF Value Sets
• ICD-10-PCS• UCUM• CPT• C154• NDC• FDA Route Administration• HL7 Vocabulary• Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition (DSM-IV)
CDS Guidance Request Transaction: Service Standards RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Decision Support Service (DSS)HITSC Rating:*M: 78.69A: 88.6SI: 33.33T: 72.71
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits: Response Metadata;
(N) Does not Fit:
Yes • One significant gap is DSS will tie to SOAP. There is significant industry movement towards REST.
• DSS has 2 levels, one is model of the service which is implementation agnostic. Could support standard with implementation based on REST, but it would have to be developed.
• DSS is designed to be able to support patient data, unlike infobutton.
• Has broader scope than infobutton
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Context Aware Retrieval Application (Infobutton)
HITSC Rating*M: 90.08A: 92.11SI: 47.62T: 82.07
(Y) Fits: Context; Supporting Evidence; Supporting Resource
(P) Partially Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response
(N) Does not Fit: Clinical; Actions; Attribute Value List; Response Meta Data
No
• Can send some patient data, but no designed to support rich patient data payload like DSS
CDS Guidance Response Transaction: Service Standards RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Decision Support Service (DSS)HITSC Rating:*M: 78.69A: 88.6SI: 33.33T: 72.71
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits: Response Metadata;
(N) Does not Fit:
Yes • One significant gap is DSS will tie to SOAP. There is significant industry movement towards REST.
• DSS has 2 levels, one is model of the service which is implementation agnostic. Could support standard with implementation based on REST, but it would have to be developed.
• DSS is designed to be able to support patient data, unlike infobutton.
• Has broader scope than infobutton
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Context Aware Retrieval Application (Infobutton)
HITSC Rating:*M: 90.08A: 92.11SI: 47.62T: 82.07
(Y) Fits: Context; Supporting Evidence; Supporting Resource
(P) Partially Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response
(N) Does not Fit: Clinical; Actions; Attribute Value List; Response Meta Data
No
• Can send some patient data, but no designed to support rich patient data payload like DSS
CDS Guidance Request Transaction: Organizer/Container RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
CDS Knowledge Artifact Implementation Guide (HeD UC1 IG)HITSC Rating:*M: 61.39A: 86.84SI: 35.71T: 64.62
(Y) Fits: (Sender) CDS Response; (Receiver) CDS Response; Clinical; Supporting Evidence; Supporting Resource; Actions; Attribute Value List;
(P) Partially Fits: Context; Response Metadata
(N) Does not Fit: Exceptions
No • UC1 is not designed to carry patient data
• If CCDA is chosen, would probably have to use related HL7 Clinical statements for the Item Payload bucket.
• If vMR is chosen, would probably have to use the vMR Clinical Statements for the Item Payload bucket
• External options may exist for transforming CCDA request into a vMR component
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Consolidated CDAHITSC Rating:*M: 53.59A: 80.70SI: 33.33T: 58.48
(Y) Fits: Clinical;
(P) Partially Fits:
(N) Does not Fit: Context, Supporting Evidence; Supporting Resource; Actions; Attribute Value List; Response Metadata; Exceptions
Yes • Can transform CCDA request into a vMR component from the execution system
• Not everything from CCDA goes easily into vMR, but vMR is designed to easily accept CCDA components
CDS Guidance Request Transaction: Organizer/Container Rationale (continued…)Standard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Virtual Medical Record (vMR)HITSC Rating:*M: 78.06A: 81.58SI: 33.33T: 70.08
(Y) Fits: Clinical; Attribute Value List
(P) Partially Fits: CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Context; Supporting Evidence; Supporting Resource; Actions;
(N) Does not Fit: Response Metadata; Exceptions
Yes • Lighter weight than the other options• Developed specifically for clinical decision
support computability. • Intended to be used for this initiative, and
has been recently enhanced in this respect
* M: Maturity A: Adoptability SI: S&I Specific T: Total
CDS Guidance Response Transaction: Organizer/Container RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
CDS Knowledge Artifact Implementation Guide (HeD UC1 IG)HITSC Rating:*M: 61.39A: 86.84SI: 35.71T: 64.62
(Y) Fits: (Sender) CDS Response; (Receiver) CDS Response; Clinical; Supporting Evidence; Supporting Resource; Actions; Attribute Value List;
(P) Partially Fits: Context; Response Metadata
(N) Does not Fit: Exceptions
Yes • Fits Clinical; Supporting Evidence; Supporting Resource; Actions data requirements
• Attribute value list is not supported in UC1 schema, however the schema does allow extensions using XSD
• Would use subset of HeD UC1 schema that may require further modifications
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Consolidated CDAHITSC Rating:*M: 53.59A: 80.70SI: 33.33T: 58.48
(Y) Fits: Clinical;
(P) Partially Fits:
(N) Does not Fit: Context, Supporting Evidence; Supporting Resource; Actions; Attribute Value List; Response Metadata; Exceptions
No • There is a profile in IHE that uses DSS and returns IHE as an output. But hasn’t been finalized within IHE
• Lacks the ability to group and organize things that UC1 does
CDS Guidance Response Transaction: Organizer/Container Rationale (continued…)
StandardSummary of
Findings from UCR Crosswalk
Keep? Rationale
Virtual Medical Record (vMR)HITSC Rating:*M: 78.06A: 81.58SI: 33.33T: 70.08
(Y) Fits: Clinical; Attribute Value List
(P) Partially Fits: CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Context; Supporting Evidence; Supporting Resource; Actions;
(N) Does not Fit: Response Metadata; Exceptions
No • Does fit this situation, however CDS Knowledge artifact may be the better option
• UC1 action would need to be modified to represent payload for UC2 regarding vMR
• May need a model agnostic response
* M: Maturity A: Adoptability SI: S&I Specific T: Total
HL7 Version 3 Standard: Order Set Publication, Release 1HITSC Rating:*M: 46.20A: 75.44SI: 33.33T: 53.31
(Y) Fits: Supporting Evidence; Supporting Resource; Response Metadata
(P) Partially Fits: Clinical; Context; Actions
(N) Does not Fit: Attribute Value List; Exceptions
No • Some vendors may want to support this as an option, however CDS Knowledge Artifact is the better option
• Not many vendors utilize this standard for this initiative
CDS Guidance Request Transaction: Item Payloads Rationale Standard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Context Aware Retrieval Application (Infobutton)HITSC RatingM: 90.08A: 92.11SI: 47.62T: 82.07
(Y) Fits: Context; Supporting Evidence; Supporting Resource
(P) Partially Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response
(N) Does not Fit: Clinical; Actions; Attribute Value List; Response Meta Data
No
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Virtual Medical Record (vMR)HITSC Rating:*M: 78.06A: 81.58SI: 33.33T: 70.08
(Y) Fits: Clinical; Attribute Value List
(P) Partially Fits: CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Context; Supporting Evidence; Supporting Resource; Actions;
(N) Does not Fit: Response Metadata; Exceptions
Yes
CDS Guidance Request Transaction: Item Payloads Rationale (Continued…)Standard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Consolidated CDAHITSC Rating:*M: 53.59A: 80.70SI: 33.33T: 58.48
(Y) Fits: Clinical;
(P) Partially Fits:
(N) Does not Fit: Context, Supporting Evidence; Supporting Resource; Actions; Attribute Value List; Response Metadata; Exceptions
Yes
* M: Maturity A: Adoptability SI: S&I Specific T: Total
HL7 Version 3 Standard: Order Set Publication, Release 1HITSC Rating:*M: 46.20A: 75.44SI: 33.33T: 53.31
(Y) Fits: Supporting Evidence; Supporting Resource; Response Metadata
(P) Partially Fits: Clinical; Context; Actions
(N) Does not Fit: Attribute Value List; Exceptions
No
CDS Guidance Response Transaction: Item Payloads Rationale Standard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Context Aware Retrieval Application (Infobutton)
HITSC Rating:*M: 90.08A: 92.11SI: 47.62T: 82.07
(Y) Fits: Context; Supporting Evidence; Supporting Resource
(P) Partially Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response
(N) Does not Fit: Clinical; Actions; Attribute Value List; Response Meta Data
No
* M: Maturity A: Adoptability SI: S&I Specific T: Total
Virtual Medical Record (vMR)HITSC Rating:*M: 78.06A: 81.58SI: 33.33T: 70.08
(Y) Fits: Clinical; Attribute Value List
(P) Partially Fits: CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Context; Supporting Evidence; Supporting Resource; Actions;
(N) Does not Fit: Response Metadata; Exceptions
Yes
CDS Guidance Response Transaction: Item Payloads Rationale (Continued…)Standard
Summary of Findings from UCR
CrosswalkKeep? Rationale
Consolidated CDA
HITSC Rating:*M: 53.59A: 80.70SI: 33.33T: 58.48
(Y) Fits: Clinical;
(P) Partially Fits:
(N) Does not Fit: Context, Supporting Evidence; Supporting Resource; Actions; Attribute Value List; Response Metadata; Exceptions
Yes
* M: Maturity A: Adoptability SI: S&I Specific T: Total
HL7 Version 3 Standard: Order Set Publication, Release 1HITSC Rating:*M: 46.20A: 75.44SI: 33.33T: 53.31
(Y) Fits: Supporting Evidence; Supporting Resource; Response Metadata
(P) Partially Fits: Clinical; Context; Actions
(N) Does not Fit: Attribute Value List; Exceptions
Yes
CDS Guidance Request Transaction: Transport RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
SOAP
HITSC Rating:*M: 100.00A: 100.00SI: 100.00T: 100.00
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:
* M: Maturity A: Adoptability SI: S&I Specific T: Total
RESTHITSC Rating:*M: 100.00A: 100.00SI: 42.86T: 88.30
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:
CDS Guidance Response Transaction: Transport RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
SOAP
HITSC Rating:*M: 100.00A: 100.00SI: 100.00T: 100.00
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:
* M: Maturity A: Adoptability SI: S&I Specific T: Total
RESTHITSC Rating:M: 100.00A: 100.00SI: 42.86T: 88.30
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:
CDS Guidance Request Transaction: Authentication/Authorization RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
SAMLHITSC Rating:*M: 100.00A: 100.00SI: 100.00T: 100.00
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:* M: Maturity A: Adoptability SI: S&I Specific T: Total
CDS Guidance Response Transaction: Authentication/Authorization RationaleStandard
Summary of Findings from UCR
CrosswalkKeep? Rationale
SAMLHITSC Rating:*M: 100.00A: 100.00SI: 100.00T: 100.00
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:* M: Maturity A: Adoptability SI: S&I Specific T: Total
CDS Guidance Request Transaction: Encryption
StandardSummary of
Findings from UCR Crosswalk
Keep? Rationale
TLSHITSC Rating:*M: 100.00A: 100.00SI: 42.86T: 88.30
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit:* M: Maturity A: Adoptability SI: S&I Specific T: Total
CDS Guidance Response Transaction: Encryption
StandardSummary of
Findings from UCR Crosswalk
Keep? Rationale
TLSHITSC Rating:*M: 100.00A: 100.00SI: 42.86T: 88.30
(Y) Fits: (Sender) CDS Request; (Receiver) CDS Request; (Sender) CDS Response; (Receiver) CDS Response; Exceptions
(P) Partially Fits:
(N) Does not Fit: * M: Maturity A: Adoptability SI: S&I Specific T: Total