Reviewed CDS standards roadmap from Clinical Decision Support Standards, which was taken from the HL7 wiki.
Discussed migration of the CDS Knowledge Artifact Specification to the FHIR-based Clinical Reasoning specification.
Discussed need for logical model that can handle transforms to/from various versions of FHIR, FHIR profiles, and vendor implementations of these which can be different.
Claude presented information from the American Medical Informatics Association (AMIA) 2019 Annual Symposium in 11/2019 on how QUICK was developed as a CIMI-based logical model for CDS and eCQM, aligned very closely with FHIR. Current state:
Floyd raised a few issues:
Bryn brought up FSH (FHIR Short Hand), a DSL for Structure Definition. A language for expressing a model. Could help with maintaining QI Core moving forward.
Isaac brought up normative FHIR resources as the way forward; perhaps this will not be an issue once we get there.
This is a generic problem across use cases beyond CDS and eCQM.
Discussed: where do we work on the complexity – at the level of the knowledge artifact, or at the level of the logical model?
Logical model(s) could be particularly useful when mapped to a FHIR Profile level (e.g., QI Core).
3 levels where this can be done (perhaps all 3 are needed):
Someone needs to do this hard work.
Feedback from vendor: we need to explain why this is needed, in a way that vendors and payors understand.
See presentation –
|Deferred due to time|