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Difference between revisions of "DecisionSupportRule FHIR Resource Proposal"

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'''Replaced by [[ActivityDefinition_FHIR_Resource_Proposal]]'''
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<div style="float: left;">[[Image:OpenHotTopic.GIF|35px| ]]</div>
 
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This page documents a [[:category:Pending FHIR Resource Proposal|Pending]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]]
 
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[[Category:FHIR Resource Proposal]]
 
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[[Category:Pending FHIR Resource Proposal]]
 
  
  
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=PutProposedResourceNameHere=
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=DecisionSupportRule=
  
 
<!-- Resource names should meet the following characteristics:
 
<!-- Resource names should meet the following characteristics:
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* Be consistent with other similar resources
 
* Be consistent with other similar resources
 
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The DecisionSupportRule resource represents the definition of a decision support rule of the form [on Event] if Condition then Action. Event-Condition-Action rules are a common and flexible mechanism of dynamically affecting clinical workflow by intercepting established points within the workflow, evaluating conditions based on the relevant context, and returning guidance in the form of actions to be taken, either by the system directly, or as part of a recommended intervention with the involvement of clinicians at the point-of-care.
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The intent of the resource is to establish a standard mechanism to enable automated sharing of the knowledge defined by the ECA rule. The resource is a concrete realization of the logical model defined by the [http://www.hl7.org/implement/standards/product_brief.cfm?product_id=337 HL7 Standard: Clinical Decision Support Knowledge Artifact Specification].
  
 
==Owning committee name==
 
==Owning committee name==
  
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<!-- The name of the committee that is proposed to have responsibility for developing and maintaining the resources. -->
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[[Clinical_Decision_Support_Workgroup|Clinical Decision Support Work Group]]
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[[YourCommitteeName]]
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==Committee Approval Date:==
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2016-02-24 - [http://wiki.hl7.org/index.php?title=File:2016-02-24_CDS_WG_Call_Minutes.docx Meeting Minutes]
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
  
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<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the resource (optional) -->
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*[[Clinical_Quality_Information_Work_Group|Clinical Quality Information Work Group]]
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* Work Group Name
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*[[Service_Oriented_Architecture|Service Oriented Architecture Work Group]]
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* or link
 
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* or "None"
 
  
 
==FHIR Resource Development Project Insight ID==
 
==FHIR Resource Development Project Insight ID==
  
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<!-- Please specify the id of your work group’s PSS for doing FHIR work.  (If submitted but not yet approved, just write “pending”.) The link to the PSS template can be found here: http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc -->
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[http://www.hl7.org/Special/committees/dss/projects.cfm?action=edit&ProjectNumber=1234 1234: FHIR-Based Clinical Quality Framework (CQF-on-FHIR)]
  
 
==Scope of coverage==
 
==Scope of coverage==
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As a rule, resources should encompass all of these aspects.
 
As a rule, resources should encompass all of these aspects.
 
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  -->
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A DecisionSupportRule is a knowledge artifact that enables automated sharing of a certain common pattern of clinical knowledge. Because it is definitional in nature, it is not a patient-specific resource. The resource captures the structure of an Event-Condition-Action rule and is flexible enough to be used to describe behaviors for any discipline and locale. It is intended to be used by decision support content vendors as a means of distributing knowledge artifacts, as well as by decision support service vendors and health care delivery systems as a means of automatically integrating decision support behavior.
  
 
==RIM scope==
 
==RIM scope==
  
 
<!-- Identify the formal RIM mapping for the root concept of the resource.  The expectation is that the RIM mapping will be sufficiently precise so as to not overlap with any other resource definition. -->
 
<!-- Identify the formal RIM mapping for the root concept of the resource.  The expectation is that the RIM mapping will be sufficiently precise so as to not overlap with any other resource definition. -->
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<!-- I'm not sure, but I don't believe there is a direct mapping of this resource to the RIM. -->
  
 
==Resource appropriateness==
 
==Resource appropriateness==
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* Have the characteristics of high cohesion & low coupling – need to explore whether coupling is good some places, not elsewhere – layers from Bo’s document  
 
* Have the characteristics of high cohesion & low coupling – need to explore whether coupling is good some places, not elsewhere – layers from Bo’s document  
 
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  -->
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Decision support interventions are a critial aspect of health care delivery, but they are often implemented as custom logic, either within an EHR directly, or as part of a decision support service that is exposed via a proprietary interface. Increasingly, decision support content vendors are making these types of rules available, but each vendor uses a proprietary format to enable the distribution of their content.
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The Clinical Decision Support Knowledge Artifact Specification provides a standard mechanism for sharing ECA rules, and enabling that content to be represented as a FHIR resource will extend the reach of that specification. In addition, defining the content as a FHIR resource will allow implementers to use the FHIR stack and all its associated tooling and specifications to expose the content, effectively enabling another potential role of a FHIR server as a Knowledge Artifact Repository.
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==Expected implementations==
 
==Expected implementations==
  
 
<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. -->
 
<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. -->
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Multiple decision support vendors have expressed interest in using the DecisionSupportRule resource to enable standards-based distribution of their content.
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<!-- I'd have to get permission to post names publicly, but ask me (Bryn Rhodes) for details. -->
  
 
==Content sources==
 
==Content sources==
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Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
 
Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
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Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=391 Clinical Quality Common Metadata Conceptual Model]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=337 Clinical Decision Support Knowledge Artifact Specification]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=97 Health Quality Measure Format]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=12 Decision Support Service]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=334 Decision Support Service Implementation Guide]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=208 Infobutton Specification]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=22 Infobutton Implementation Guide]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=283 SOA Infobutton Implementation Guide]
  
 
==Example Scenarios==
 
==Example Scenarios==
  
 
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource.  They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) -->
 
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource.  They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) -->
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===Chlamydia Screening===
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When seeing a patient that meets the criteria defined by Chlamydia Screening guidelines, clinicians should ensure that the appropriate testing has been performed. The logic to capture this intervention can be represented as a DecisionSupportRule.
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===Exclusive Breastfeeding===
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When admitting a new mother for delivery, appropriate interventions to ensure the mother receives education regarding exclusive breastfeeding can be represented as a DecisionSupportRule.
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This scenario will be piloted as part of the CQF-on-FHIR track at the May 2016 Connectathon.
  
 
==Resource Relationships==
 
==Resource Relationships==
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Reference to resources is really only relevant at the "same or higher level" (Bo – fix this wording)
 
Reference to resources is really only relevant at the "same or higher level" (Bo – fix this wording)
 
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This resource will make use of the [http://hl7.org/fhir/2016May/library.html Library] resource to represent any logic involved in the ECA rule.
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The _evaluate_ operation uses the [https://hl7-fhir.github.io/guidanceresponse.html GuidanceResponse] resource to return its results.
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In addition, the resource makes use of the following common data types:
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* [http://hl7.org/fhir/2016May/modulemetadata.html ModuleMetadata]
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* [http://hl7.org/fhir/2016May/triggerdefinition.html TriggerDefinition]
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* [http://hl7.org/fhir/2016May/Actiondefinition.html ActionDefinition]
  
 
==Timelines==
 
==Timelines==
  
 
<!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting -->
 
<!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting -->
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May 2016 Ballot Cycle in support of the [http://hl7.org/fhir/2016May/cqif/cqif.html CQF IG].
  
 
==gForge Users==
 
==gForge Users==
  
 
<!-- Identify the userids who will require commit access to gForge to maintain the resource.  (Ensure all users have registered for gForge.) -->
 
<!-- Identify the userids who will require commit access to gForge to maintain the resource.  (Ensure all users have registered for gForge.) -->
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brynrhodes

Latest revision as of 20:35, 20 July 2016

Replaced by ActivityDefinition_FHIR_Resource_Proposal



DecisionSupportRule

The DecisionSupportRule resource represents the definition of a decision support rule of the form [on Event] if Condition then Action. Event-Condition-Action rules are a common and flexible mechanism of dynamically affecting clinical workflow by intercepting established points within the workflow, evaluating conditions based on the relevant context, and returning guidance in the form of actions to be taken, either by the system directly, or as part of a recommended intervention with the involvement of clinicians at the point-of-care.

The intent of the resource is to establish a standard mechanism to enable automated sharing of the knowledge defined by the ECA rule. The resource is a concrete realization of the logical model defined by the HL7 Standard: Clinical Decision Support Knowledge Artifact Specification.

Owning committee name

Clinical Decision Support Work Group

Committee Approval Date:

2016-02-24 - Meeting Minutes

Contributing or Reviewing Work Groups

FHIR Resource Development Project Insight ID

1234: FHIR-Based Clinical Quality Framework (CQF-on-FHIR)

Scope of coverage

A DecisionSupportRule is a knowledge artifact that enables automated sharing of a certain common pattern of clinical knowledge. Because it is definitional in nature, it is not a patient-specific resource. The resource captures the structure of an Event-Condition-Action rule and is flexible enough to be used to describe behaviors for any discipline and locale. It is intended to be used by decision support content vendors as a means of distributing knowledge artifacts, as well as by decision support service vendors and health care delivery systems as a means of automatically integrating decision support behavior.

RIM scope

Resource appropriateness

Decision support interventions are a critial aspect of health care delivery, but they are often implemented as custom logic, either within an EHR directly, or as part of a decision support service that is exposed via a proprietary interface. Increasingly, decision support content vendors are making these types of rules available, but each vendor uses a proprietary format to enable the distribution of their content.

The Clinical Decision Support Knowledge Artifact Specification provides a standard mechanism for sharing ECA rules, and enabling that content to be represented as a FHIR resource will extend the reach of that specification. In addition, defining the content as a FHIR resource will allow implementers to use the FHIR stack and all its associated tooling and specifications to expose the content, effectively enabling another potential role of a FHIR server as a Knowledge Artifact Repository.


Expected implementations

Multiple decision support vendors have expressed interest in using the DecisionSupportRule resource to enable standards-based distribution of their content.


Content sources

Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->

Example Scenarios

Chlamydia Screening

When seeing a patient that meets the criteria defined by Chlamydia Screening guidelines, clinicians should ensure that the appropriate testing has been performed. The logic to capture this intervention can be represented as a DecisionSupportRule.

Exclusive Breastfeeding

When admitting a new mother for delivery, appropriate interventions to ensure the mother receives education regarding exclusive breastfeeding can be represented as a DecisionSupportRule.

This scenario will be piloted as part of the CQF-on-FHIR track at the May 2016 Connectathon.

Resource Relationships

This resource will make use of the Library resource to represent any logic involved in the ECA rule.

The _evaluate_ operation uses the GuidanceResponse resource to return its results.

In addition, the resource makes use of the following common data types:

Timelines

May 2016 Ballot Cycle in support of the CQF IG.

gForge Users

brynrhodes

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