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Chair: Bryn Rhodes

Scribe: Howard Strasberg


Discussion items

  • CDS hooks update
    • Isaac Vetter and Dennis Patterson presented an update
    • https://bit.ly/cds-hooks202005
    • NIB for enhancements for Sept 2020 cycle
    • Looking at maturing hooks other than patient-view
    • Argonaut PAMA IG used CDS hooks very heavily
    • DaVinci has also used it for coverage requirements discovery (CRD)
    • 1.1 roadmap
      • Override reasons
        • series of codes
      • Feedback service
      • Refinements to CDS hooks response
        • suggestion.isRecommended
        • card.source.topic
    • Connectathon update
      • 1.0 spec - several CDS clients and CDS services participated
      • 1.1 candidates - fewer participants, but still at least a few clients and services
        • e.g. override reasons
        • UUID identifier for cards
        • public sandbox has been enhanced accordingly
      • issues
        • feedback for SMART app launches
          • might be able to use appContext
          • no direct mechanism
        • capturing override reasons and card topics
        • sandbox should default to FHIR R4
        • additional customizations
      • next steps
        • 1.1 publication
        • advancing maturity of hooks
        • capturing best practices
        • future Connectathons
          • SMART web messaging
          • advertisement of service preconditions
          • system actions
    • Discussion
      • override reasons at suggestion level vs card level
      • would providers actually take the time to provide override reasons at the suggestion level?
      • Bryn - potential drug-drug interaction (PDDI) discussed at Clinical Reasoning track
        • configuration options using extensions in the spec
        • should configuration options, or at least guidance for it, be included the base spec for 1.1?
        • Dennis
          • with feedback service, service would be aware that a particular user was overriding a card for a particular reason
          • PDDI allows CDS client to opt in to certain functionality, such as caching responses
        • is it important for CDS service to be stateless?
        • could be hard to provide guidance in base spec when the spec is hook-agnostic
        • Isaac - extensions in both CRD and PDDI
          • who is setting these parameters?  individual clinicians?  if so, how?
          • please notify Isaac/Dennis/Bryn of any CDS hooks implementations - may affect maturity level of various hooks
          • CDS hooks availability page is available
        • patient-view ballot
          • all issues except one have been resolved
        • 1.1 ballot - NIB deadline is July 5
  • FHIR Cast update - Isaac
    • https://bit.ly/fhircast202005 
    • context synchronization spec
    • wrapping up STU2 ballot, which added support for Websockets
    • 2020 roadmap
      • release STU2 spec
      • direction for image measurement exchange
  • Clinical Reasoning update - Bryn
    • resources/IG overview (CDS/CQI)
      • resources in FHIR spec
        • e.g. ActivityDefinition, PlanDefinition, Measure, MeasureReport, Library, DetectedIssue, Evidence, Citation
      • CDS hooks
      • CQL
      • Infobutton
      • Quality Measure IG
      • Data exchange for quality measures
      • PDDI
      • CPG-on-FHIR
      • EBM-on-FHIR
    • FMG questions
      • which resources are we planning to take normative in the next release?
        • none
        • http://build.fhir.org/versions.html#maturity
        • however, we could reasonably say that Measure and MeasureReport could reasonably go to maturity level 4
        • PlanDefinition - 4
        • Library - 4
        • ActivityDefinition - 3
        • RiskAssessment - 2
        • DetectedIssue - 2
      • see Google Drive link above for additional FMG questions and answers
      • some discussion of R5 timeline, especially given R4 regulatory requirement in the US
      • we can now configure versions for specification feedback on IGs
      • new workflow for project proposals
  • Infobutton on FHIR
    • project 1280
    • was a proposal for an IG
    • motion to close project 1280: Howard Strasberg/Peter Muir: approved 17/0/0
  • Project 939 - VMR for CDS
    • Withdrawal - vMR for CDS
    • was balloted but not published
    • DAM for VMR
    • we need to withdraw or retire the specification
    • since it was never published, withdrawal makes more sense
    • we published the logical model, not the domain analysis model
    • motion to withdraw project 939: Ken Kawamoto / Howard Strasberg: approved 16/0/0
  • Project 931 - CDS KAS
    • Withdrawal - CDS KAS
    • was published several times
    • we would like to retire this one
    • motion to retire: Howard Strasberg / Peter Muit: approved 16/0/0
  • Next meeting 5/21 12-2 PM EDT