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Difference between revisions of "201605 CDS Enablement Services"

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In order to provide effective and timely clinical decision support, a number of enabling infrastructure capabilities are necessary.  This track explores and exploits capabilities available within the FHIR spec, and will illustrate how SOA services can complement these core capabilities as part of enablement of CDS.
 
In order to provide effective and timely clinical decision support, a number of enabling infrastructure capabilities are necessary.  This track explores and exploits capabilities available within the FHIR spec, and will illustrate how SOA services can complement these core capabilities as part of enablement of CDS.
  
 +
'''Note that there is another CDS related track at this connectathon''' [http://wiki.hl7.org/index.php?title=201605_CDS_Hooks_Connectathon_Track_Proposal]
  
 
==Proposed Track Lead==
 
==Proposed Track Lead==
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==Expected participants==
 
==Expected participants==
<!-- List of the individuals and/or organizations that have indicated a desire to attend the connectathon and implement this track -->
 
 
The expected participants include:
 
The expected participants include:
 
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* Cognitive Medical System
 +
* Database Solutions
 +
* Health Samurai
 +
* Intermountain HealthCare
 +
* OSIA Medical
 +
* Partners Healthcare
 +
* Regenstrief
 +
* University of Utah
  
 
==Roles==
 
==Roles==
<!-- Roles are sets of functionality (generally defined by a Conformance resource) that a single system can take on -->
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The CDS Enablement Service consists of four roles to support the proposed tracks:
===FHIR Client===
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===SOA Services===
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
FHIR Client will....
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* A Publish and Subscribe Service which exposes interfaces for the registration of users and the association of users as subscribers and publishers to topics and for the management of topics.
 +
* A Unified Communication Service allowing communications directed towards human recipients and which supports functionality such as sending messages to recipients across various channels and escalating messages to other recipient.
  
===FHIR Server===
+
===SOA Service Clients===
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
FHIR Server will....
+
* Publish and Subscribe Clients for the relevant interfaces of the Event Publish and Subscribe Service Functional Model such as publishing, subscribing, topic management, etc...  
 +
* A Unified Communication Client that supports sending messages to the UCS broker and can query the UCS broker.
  
 
==Scenarios==
 
==Scenarios==
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=== 1. Notify the primary care provider using EMR alert ===
 
=== 1. Notify the primary care provider using EMR alert ===
Precondition: A clinical process necessitates alerting a provider
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'''Precondition''':  
Action:  
+
 
 +
A clinical process necessitates alerting a provider
 +
 
 +
'''Action''':  
 +
 
 
Determine the notification payload to be sent
 
Determine the notification payload to be sent
 +
 
Determine addressing of recipient
 
Determine addressing of recipient
 +
 
Submit alert message to recipient
 
Submit alert message to recipient
Success Criteria: Primary care provider receives alert in "EMR" inbox
+
 
Bonus Point:  
+
'''Success Criteria''':  
 +
 
 +
Primary care provider receives alert in "EMR" inbox
 +
 
 +
'''Bonus Point:'''
 +
 
 
Use decision support to determine notification message
 
Use decision support to determine notification message
  
 
=== 2. Select recipient based upon clinical role ===
 
=== 2. Select recipient based upon clinical role ===
 
Reroute (failover) message to provider along a different modality (e.g., eMail or SMS)
 
Reroute (failover) message to provider along a different modality (e.g., eMail or SMS)
Precondition: Original alert message sent to provider is not acknowledged in a timely manner.
+
 
Action:  
+
'''Precondition''':
 +
 
 +
Original alert message sent to provider is not acknowledged in a timely manner.
 +
 
 +
'''Action''':  
 +
 
 
Determine that message rerouting is required
 
Determine that message rerouting is required
 +
 
Determine recipient addressing for a new communication channel
 
Determine recipient addressing for a new communication channel
 +
 
Submit message to recipient using alternative communication channel
 
Submit message to recipient using alternative communication channel
Success Criteria: Recipient receives message on the right device
+
 
Bonus Point(s):  
+
'''Success Criteria:'''
 +
 
 +
Recipient receives message on the right device
 +
 
 +
'''Bonus Point(s): '''
 +
 
 
Select alternative payload based on new communication channel and its HIPAA compliance
 
Select alternative payload based on new communication channel and its HIPAA compliance
 +
 
Select preferred modality based on recipient’s preference profile
 
Select preferred modality based on recipient’s preference profile
  
 
=== 3. Escalate message to next-in-charge via alert ===
 
=== 3. Escalate message to next-in-charge via alert ===
Precondition: Original alert message sent to provider is not acknowledged in a timely manner.
+
'''Precondition''':  
 +
 
 +
Original alert message sent to provider is not acknowledged in a timely manner.
 +
 
 
There is a named alternate (next-in-charge or surrogate) specified.
 
There is a named alternate (next-in-charge or surrogate) specified.
Action:  
+
 
 +
'''Action''':  
 +
 
 
Determine that message escalation is required
 
Determine that message escalation is required
 +
 
Determine new recipient addressing for the alert
 
Determine new recipient addressing for the alert
 +
 
Submit message to proper recipient
 
Submit message to proper recipient
Success Criteria: Next-in-charge receives alert
+
 
Bonus Point:  
+
'''Success Criteria''':  
 +
 
 +
Next-in-charge receives alert
 +
 
 +
'''Bonus Point:'''
 +
 
 
Select escalation recipient based upon clinical role
 
Select escalation recipient based upon clinical role
Escalate to recipient using alternative communication channels
+
 
 +
Escalate to recipient using alternative communication channels

Latest revision as of 21:53, 6 April 2016

Return to May 2016 Proposals

CDS Enablement Services

If creating a client, this track should require minimal work in advance of the connectathon, though at least a bit of preparation/reading on FHIR is recommended. If creating a server, advanced preparation will be required, but this scenario should somewhat limit the effort involved.

Pre-requisites: none

Submitting WG/Project/Implementer Group

Clinical Decision Support (CDS) with support from Service-oriented Architecture (SOA)

Justification

In order to provide effective and timely clinical decision support, a number of enabling infrastructure capabilities are necessary. This track explores and exploits capabilities available within the FHIR spec, and will illustrate how SOA services can complement these core capabilities as part of enablement of CDS.

Note that there is another CDS related track at this connectathon [1]

Proposed Track Lead

Coordinator: Claude Nanjo (Cognitive)

Expected participants

The expected participants include:

* Cognitive Medical System 
* Database Solutions
* Health Samurai
* Intermountain HealthCare
* OSIA Medical
* Partners Healthcare
* Regenstrief
* University of Utah

Roles

The CDS Enablement Service consists of four roles to support the proposed tracks:

SOA Services

  • A Publish and Subscribe Service which exposes interfaces for the registration of users and the association of users as subscribers and publishers to topics and for the management of topics.
  • A Unified Communication Service allowing communications directed towards human recipients and which supports functionality such as sending messages to recipients across various channels and escalating messages to other recipient.

SOA Service Clients

  • Publish and Subscribe Clients for the relevant interfaces of the Event Publish and Subscribe Service Functional Model such as publishing, subscribing, topic management, etc...
  • A Unified Communication Client that supports sending messages to the UCS broker and can query the UCS broker.

Scenarios

Publish & Subscribe Use Cases:

1. Register a new publisher

Precondition: EPS service is running

Action:

Publisher registers as a credentialed and identified publisher

Success Criteria:

Publisher successfully registered

2. Publish against a topic

Precondition: Successful registration of publisher

Action:

An event is published to designated topic

Success Criteria: Publisher successfully populates broker topic

Bonus Point: Broker implements ability for a published event to be moderated - i.e. held until approved

3. Subscribe to a specific topic

Precondition: Desired topic identified

Action:

Query available topics associated with the broker

Subscribe to one of the specific topics

Success Criteria:

Successfully establish a pull subscription

Bonus Point:

Successfully subscribe to a topic and receive push subscriptions

4. Receive a published event

Precondition:

Successful subscription

Action:

Server receives a request to publish an event on a topic

Server processes request and publishes the event to the topic

Success Criteria:

Successfully receive events from a pull subscription

Bonus Point:

Successfully receive events from a push subscription

5. Create a new topic

Precondition:

Successful registration, common topic tree, agreement on topic body

Action:

Review topic tree

Add new topic at the right point in the hierarchy

Success Criteria:

New topic appears on the topic tree

Bonus Point:

Support deferred topic create until topic parent owner approves insertion

Notify Care Team Use Cases:

1. Notify the primary care provider using EMR alert

Precondition:

A clinical process necessitates alerting a provider

Action:

Determine the notification payload to be sent

Determine addressing of recipient

Submit alert message to recipient

Success Criteria:

Primary care provider receives alert in "EMR" inbox

Bonus Point:

Use decision support to determine notification message

2. Select recipient based upon clinical role

Reroute (failover) message to provider along a different modality (e.g., eMail or SMS)

Precondition:

Original alert message sent to provider is not acknowledged in a timely manner.

Action:

Determine that message rerouting is required

Determine recipient addressing for a new communication channel

Submit message to recipient using alternative communication channel

Success Criteria:

Recipient receives message on the right device

Bonus Point(s):

Select alternative payload based on new communication channel and its HIPAA compliance

Select preferred modality based on recipient’s preference profile

3. Escalate message to next-in-charge via alert

Precondition:

Original alert message sent to provider is not acknowledged in a timely manner.

There is a named alternate (next-in-charge or surrogate) specified.

Action:

Determine that message escalation is required

Determine new recipient addressing for the alert

Submit message to proper recipient

Success Criteria:

Next-in-charge receives alert

Bonus Point:

Select escalation recipient based upon clinical role

Escalate to recipient using alternative communication channels