2020-09-22 1000-1130 CDS WGM Minutes

Date:  2020-09-22

Quarter:  1000-1130

Chair:  Bryn Rhodes

Scribe:  Robert Jenders

Joint Meeting:  CDS WG hosting CQI WG

Agenda

• CDS Hooks Connectathon Report out and Project Update/Ballot Triage
• FHIRCast Project Update
• FHIRCast Trackers

Minutes

1. CDS Hooks
   1. Isaac Vetter reported on this standard in the Connectathon and provided updates regarding this project, including a brief primer on the standard itself.
   2. WG members generally discussed various uses and potential implementations of the standard.
   3. CDS Hooks 1.1
      1. Current, published version = 1.0.
      2. Work on v1.1 started last year as an augmentation of v1.0.
      3. Added features: 
         1. Generally, the v1.1 updates allow a CDS service to receive computable data regarding acceptance or rejection of CDS recommendations to clinicians.
         2. Practically this resulted in inclusion of several constructs in CDS Hooks:  "override reasons"; a "feedback service"; and refinements to the CDS Hooks-mediated response, while preserving backward compatibility.  
      4. Approximately 100 recent ballot comments, now undergoing review.
   4. Connectathon Report
      1. Dennis Patterson reported on CDS Hooks activity in the recent HL7 Connectathon which featured a mix of CDS vendors, including CDS service providers and consumers (EHR system vendors).
      2. Scenarios included:  Override reasons, feedback service and CDS cards.
      3. Discussions for future features:  "trigger guards" (allow a CDS service to constrain notifications); mechanisms to reduce alert fatigue.  
      4. Next steps:  v1.1 ballot comment processing; capturing best practices; solicit suggestions for future features.
2. FHIRcast Project Update
   1. Isaac Vetter provided a description of FHIRCast and described recent activity.
      1. FHIRCast is intended to be a Web-based mechanism for context synchronization with a flavor similar to the CCOW standard.
      2. Goal for 2020-2021:  Release STU2 specification and deploy.
      3. This standard was involved in the recent Connectathon, too, with several vendors.  
3. CDS FHIR Tracker Items 
   1. Issue FHIR-20825 
      1. Unable to isolate which practitioner should be doing which action in a recommendation.
      2. Proposed solution:  Add PlanDefinition.actor that will allow specification of an actor type and a role.
      3. Motion to approve van den Heuvel, second Eisenberg.  Vote:  31/0/1.
   2. Issue FHIR-27752
      1. Proposal:  Add to PlanDefinition an optional name such that the output and input elements would have a string requirement = a human-readable name for a data element requirement.
      2. Motion to approve Hamlin, second Samples.  Vote:  29/0/3.