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201605 CQF on FHIR Connectathon Track Proposal

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CQF on FHIR

This track is intended to exercise several scenarios related to clinical quality that will exercise the resources defined by the Clinical Decision Support and Clinical Quality Information Work Groups.

Submitting WG/Project/Implementer Group

Justification

The CDS and CQI Work Groups are incorporating feedback from previous ballots, the prior connect-a-thon, as well as other work groups to refine and improve the structures used to enable the representation and evaluation of quality artifacts using FHIR. This effort has resulted in a combined CQF IG that will be balloted in the May cycle. The scenarios in this connect-a-thon track proposal are intended to support that ballot by exercising key resources and use cases in the IG.


Proposed Track Lead

  • Bryn Rhodes
    • Email: bryn at databaseconsultinggroup dot com
    • Skype: bryn.rhodes

Expected participants

  • Partners Healthcare [Immunization Guidance Scenario]
  • Cognitive Medical Systems
  • University of Utah Healthcare
  • ESAC, Inc

Roles

Guidance Service

A FHIR Server that implements the $evaluate operation as defined on the DecisionSupportModule resource.

Guidance Client

A client that consumes guidance from a FHIR Server using the $evaluate operation.

Knowledge Management Repository

A FHIR Server that implements search and retrieval functionality for the various quality artifact resources.

Knowledge Artifact Consumer

A system that consumes knowledge artifacts from a knowledge management repository

Measure Reporting Service

A system that provides measure evaluation results

Scenarios

The Clinical Quality Framework Implementation Guide provides documentation for the resources that will be exercised by the above roles. Specifically, the following resources are utilized as part of those scenarios:

IHE Radiology Guidance Request Scenario

Action: A Guidance Client issues an $evaluate operation to a Guidance Service against the IHE Radiology Appropriateness Decision Support Service Module
Precondition: The GuidanceService must have the $evaluate operation implemented and be able to process requests for the IHE Radiology Appropriateness Knowledge Module
Success Criteria: The Guidance Client receives an appropriately filled GuidanceResponse and the appropriate resources for the radiology request as described in the IHE Radiology Appropriateness IG.
Bonus point:

CDC Immunization Guidance Scenario

Action: A Guidance Client issues an $evaluate operation to a Guidance Service against the CDC Immunization Decision Support Service Module. The parameters to the module are:
  • patient - The patient for which immunization guidance will be returned. The birthDate and gender should be provided.
  • organizationId - The Id of the requesting organization. For the purposes of this connect-a-thon, use the hardcoded value 'FHIR_CONNECT_A_THON'
Precondition: The GuidanceService must have the $evaluate operation implemented and be able to process requests for the CDC Immunization Decision Support Service Module.
Success Criteria: The Guidance Client receives appropriate immunization guidance based on the patient information provided in the request. The service provides guidance using the current CDC Immunization Guidelines. The test script is written with a male infant and receives an appropriate immunization schedule as ImmunizationRecommendation resources.
Bonus point: Handle error scenarios including:
  • Unauthorized: Perform the request with an invalid organization ID
  • Incomplete: Perform the request without providing birth date or gender. The response will still provide an immunization schedule, but with appropriate warnings about the use of clinical judgement in administering immunizations.
  • Malformed: Perform the request with invalid data. The response will be an OperationOutcome with an appropriate description of the error that occurred.

Knowledge Management Repository

Action: A Knowledge Artifact Consumer uses a Knowledge Management Repository to locate and retrieve a decision support rule, order set, library, and measure related to a specific condition.
Precondition: The Knowledge Management Repository must contain the artifacts and be able to respond to the search requests.
Success Criteria: The Artifact Consumer receives the knowledge management artifacts and is able to use them to drive decision support and quality measurement within their system.

Measure Reporting Service

Action: A Measure Reporting Service uses a previously retrieve knowledge artifact definition to drive measure evaluation and reports the results using the MeasureReport resource.
Precondition: The Measure Reporting Service has ingested a measure retrieve from a knowledge management repository.
Success Criteria: The MeasureReport result contains the results of evaluating the measure, and there is evidence within the reported results of having followed the related decision support artifacts at the point of care.

TestScript(s)

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