January 2024 Ballot
| Task | Assigned To | Due |
|---|---|---|
| Grammar changes (expand to include stop) | Bryn | End of Nov |
| Refactor to use CRMI | Bryn | End of Nov |
| Fix bugs (including immunization) | Taylor | End of Nov |
| Checklists | Bryn | End of Nov |
| Pull out examples | Taylor | End of Nov |
| Relationships to other initiatives | Maria | End of Nov |
| Capability Statements | Bryn | |
| $apply | Taylor | |
| $questionnaire | Brenin | |
| Audit | Derek | |
| Case features (better documentation & guidance) | Rob | |
| Extension to clinical reasoning on FHIR (how to use CPG w/ CDS Hooks) | Brian | |
| Operation test cases | Brian |
- Discuss and potentially address use cases that aren't traditionally seen as guideline-based care (i.e. generalize to expressing a Computable Care Process?)
- Updated Checklists - Bryn
- https://hl7.org/fhir/uv/cpg/methodology.html#validate-checklists
- Input/Output expectations for each level
- Survey of known tooling for authoring efforts
- Incorporate feedback/content from the GIN-NA Workshop Effort
- Provide guidance for publishing (potentially as part of the checklists) content IGs and suggest use of FHIR Community Process and fhir.org
- Infrastructure-level - Bryn
- Refactor to use CRMI IG
- Refactor to use SDC
- Example refresh/fixes
- General errata/bitrot
- New types of examples? Multi-CPG examples?
- Pull examples (other than illustrative examples for profiles) into their own IGs instead of having a "multi-ig ig"
- Only the Activity Examples (and any others required for demonstrating use of a CPG profile) would remain, all the other examples would be their own IGs
- Would they be balloted themselves, or would they be fhir.org IGs?
- Would need to follow CRMI (transitively because they would be following CPG)
- i.e. naming conventions, package ids, canonical roots, etc.
- Updated Capability Statements
- Specifically identifying roles and "services" for enabling/delivering guideline-based care
- Apply operation updates
- $questionnaire - Given a PlanDefinition and a CaseFeatureDefinition, build a questionnaire to support establishing this
- Deprecate CarePlan/$apply
- Elaborate/expand Case Feature Definition, especially relationship to PlanDefinition and Questionnaire
- Expand CPG grammar with implementation feedback - Derek
- Specifically - Stop an order generally
- NOTE: This is an especially important and potentially difficult use case that we should prioritize for this STU2 update
- Gather specific use cases we want to support
- Stop a particular medication (Aspirin)
- Change a particular medication (ANC Iron Supplement) - Done using a correlated Stop and Start
- Stop a particular therapy (servicerequest)
- Change a particular therapy - Done using a correlated Stop and Start
- Recommend that changes are always done using a correlated Stop and Start
- Documenting a clinical assessment as part of the workflow
- CPGClinicalImpression but there is no activity model for adding it to a CPG
- Update immunization activity to use MedicationRequest and deprecate use of ImmunizationRecommendation
- Usage updates/case studies? - Maria Michaels
- Examples of where we know CPG has been used
- Getting any case studies from vendors that would be willing to share
- Patterns...
- https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v5.0.0
- Especially negation statements
- Potentially bring this as a topic to IPS - xSDO governance group - Derek Ritz
- Potentially add discussion of regulatory/policy considerations?
- Assessment of relationship/interaction with
- EBM-on-FHIR - Especially documenting and discussing the touchpoints between an EBMRecommendation and a CPGRecommendation
- eCaseReport
- MedMorph
- mCode
- MCC - http://hl7.org/fhir/us/mcc/2023Sep/
- QM/DEQM
- BPM+
- CDS Hooks
- OpenCDS - https://www.opencds.org/
- Label2Enable - https://label2enable.eu/ EU-led initiative operationalizing an ISO specification about regulation of software-based therapeutics
- Discussion of auditing
- How auditing would be represented
- How auditing would be expected to be applied to each element of the grammar
https://hl7.org/fhir/uv/sdc/artifacts.html#behavior-capability-statements
Could usefully abstract the sequence diagrams from ANC for generic processes:
The above are implementation side, would also need to define actors for
- CPG Authoring (potentially derivative of CRMI Artifact Authoring Repository)
- CPG Execution
- CPG Application
- CPG Clinical Data Repository
- CPG Artifact Repository (derivative of CRMI Artifact Repository)
- CPG Terminology Service (derivative of CRMI Artifact Terminology Service)
- CPG Manager (analogous to SDC Form Manager) that combines the capabilities of a CRMI Publishable Artifact Repository and a CRMI Artifact Terminology Service)
As part of this, we would identify the relationship/overlap/boundary with SDC roles
Workstreams:
- Checklist update
- Input/Output expectations - Bryn
- Survey of tools (data dictionary, decision tables, test case descriptions, flow diagrams)
- Services
- Operations
- Patterns/Use Cases
- Case Studies
- Known implementations
- A short description of the intended use cases (therapeutic area, workflow target)
- A brief overview of technology used (e.g. Java open source)
- If possible/willing, a summary of any challenges/opportunities the project/usage highlighted
- 1. What is the use case?
- 2. Where is it being used (e.g., healthcare organization, EHR platform)?
- 3. How is it being used?
- 4. Any feedback on usage (including pilot testing results)?
- 5. Any specific technical challenges with implementing the specification?
- Known implementations
- Relationships