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Date  

Time 2-3pm ET/1-2pm CT

Meeting Materials

  1. Watch the meeting recording.
  2. Take a look at the slide deck: CardX_CommunityCall_20220916.pdf
  3. Complete survey on CardX priorities and opportunities for participation by September 23.

Attendees

Abdul Abdullah (American Heart Association (AHA)), Christine Rutan (AHA), Courtney Goodwin (AHA), Drew Mills (AHA), jennifer hall (AHA), Kathleen LaPoint (AHA), Patrick Dunn (AHA), Thomas Getchius (AHA), Corey Smith (American Medical Association (AMA)), Monique van Berkum (AMA), Yair Saperstein (AvoMD), Craig Reister (Boston Scientific), Bob Miller (CancerLinQ,  American Society of Clinical Oncology), A Talke (CardioHealth), Hilary Wall (CDC Million Hearts), James Tcheng (Center for Intelligent Health Care (CIHC)), John Windle (CIHC), Thomas Windle (CIHC), Richard Moldwin (College of American Pathologists (CAP)), Helen Burstin (Council of Medical Specialty Societies (CMSS)), Datta K (Datasherpa), Kyle Cobb (Department of Health and Human Services (HHS)), Albert Stevens (EBSCO Clinical Decisions), Jessica Cronin (EBSCO Information Systems), Ruben Nazario (EBSCO Information Systems), Will Dark (Epic), David Brick (Evicore), Steve Nichols (GE), Anastasia Reyes (Guideline Central), Meghan Wilson (Guideline Central), Harry Solomon (IEEE), Dean Cates (Intelerad), Joe Davis (Intelerad), Patrick Cambas (Intelerad), JD Liddil (M2GEN), Alexander Blood (Mass General Brigham), M S (Mathematica), Andy Iverson (Medtronic), Drew Nelson (Medtronic), Andre Quina (MITRE), Karen Bates (MITRE), Liz Canzone (MITRE), Nicole Ng (MITRE), Robert Dingwell (MITRE), Rute Martins (MITRE), Sutin Chen (MITRE), Melissa Starkey (Nextgen), David Dorr (Oregon Health Sciences University), Paul Petronelli (PALM Associates), Simon Dagenais (Pfizer), Martin Rosner (Philips), Timon Grob (Philips), Peter Muir (PJM Consulting), Kim Ball (POCP), Michele Galioto (POCP), Danielle Sill (Public Health Informatics Institute (PHII)), Lina Saintus (PHII), Kaushal Parekh (Roche), Eric Martin (Siemens Healthineers), Tom Stanis (StoryHealth), Rebecca Metzger (Telligen), Reed Gelzer (Trustworthy HER), Bruce Bray (University of Utah), Waleed Irani (Vanderbilt Heart and Vascular).

Agenda

TopicSpeaker(s)

Introductions

Melissa Christian; CardX Coordinator/Center for Intelligent Health Care (CIHC)

Welcome to CodeX

Dr. Su Chen; CodeX Clinical Director/MITRE

Introduction to CardX

Dr. Jimmy Tcheng; CardX Champion/CIHC

First CardX Use Case: Hypertension Management

Dr. Jimmy Tcheng; CardX Champion/CIHC

Tom Windle; CIHC

How to Get Involved

Rute Martins; CardX Domain Coordinator/MITRE

Hilary Wall; CDC Million Hearts

Themes of Discussion

  • CardX is a new member-driven domain in the CodeX FHIR Accelerator.
    • Focus is to enable sharing of liquid, high-quality data for the cardiovascular domain.
    • In the spirit of CodeX, CardX will focus on use-case driven standards development with a strong focus on implementation.
    • CardX will also have a foundation of core, interoperable and expert-validated cardiovascular data elements.
  • First use case focused on hypertension management:
    • Hypertension is a burning platform that is not being paid enough attention. There is enormous opportunity to bring practice closer to the guidelines.
    • Focus on exchanging data between EHR and PHR, and bringing data in from home-based blood pressure monitoring devices.
  • Getting involved:

Barriers/Obstacles and Opportunities

Incentives as a barrier to widespread adoption:

  • Tom Stanis (StoryHealth): incentives have been missing to get the community to implement, including clinicians and payers.
  • Hilary Wall (CDC): financial incentives are certainly important, but consumer demand (both patients and providers) is important as well. Self-measured blood pressure is a use case for patient-generated health data. If we solve this, the implications are much broader.
  • Paul Petronelli (Cardiac Patterns/PALM Associates, Inc.): Using FHIR as a basis for this work will be a good approach.
  • Su Chen (CodeX Program Management, MITRE): 2022 is prime time for promoting the conversation around interoperable Cardiovascular data again. By the end of 2022, a large swath of the market will be required to have FHIR APIs in place. Health systems are also becoming more proactive and interested in the quality of exchanged data.

Opportunities for Hypertension Management use case:

  • Hilary Wall (CDC): This is an opportunity to jump-start self-measured blood pressure monitoring, a space many federal agencies are involved in, as well as a broader community. This community, and Community Health Centers in particular, can be mobilized to support implementation efforts.
  • Tom Stanis (StoryHealth): StoryHealth will be joining CodeX as an implementer/developer member and is eager to contribute.
  • Yair Saperstein (AvoMD): AvoMD works to translate clinical guidelines inside and outside of the EHR and we are eager to contribute as implementers as well.

Community Suggestions

Simplify translation of guidelines into computable artifacts

  • Thomas Getchius (American Heart Association): What is missing from existing guidelines to make them more computable? Is the PICO(T) format not enough?
  • Tom Windle (CIHC): It is, but there are a lot of specific decisions involved in interpreting the language in the guidelines to make it concrete enough to be machine-readable.
  • Hilary Wall (CDC): Please see the work of "Adapting Clinical Guidelines for the Digital Age" and FHIR Clinical Guidelines.
  • John Windle (CIHC): Humans are very sophisticated at interpreting guideline language, as opposed to computers which require specificity.
  • Helen Burstin (Council of Medical Specialty Societies - CMSS): Performance measures should be considered at the time of guideline writing.

Other initiatives and resources

  • David Dorr (Oregon Health Sciences University - OHSU): OHSU has published a draft, open source FHIR IG for Hypertension Management and we've offered it openly to this group to explore with only the request that you retain attribution for the work we did, funded by AHRQ.
  • Danielle Sill (Public Health Informatics Institute - PHII): PHII has published a report on self-measured blood pressure monitoring, including existing standards in this space.
  • Reed Gelzer (Trustworthy EHR): Regarding necessary conditions for data normalization in EHR Systems, make sure to incorporate an existing standard that has been incorporated by reference as U.S. law. ASTM E-2147-18 provides Standards for EHR audit functions and audit reporting functions.

Next Steps

  • All: Complete survey on CardX priorities and opportunities for participation by September 23.
  • CardX Champions and Coordinators: Connect with organizations that are interested in more in-depth discussions on CardX, the Hypertension Management use case, and becoming a CodeX member.
  • CodeX Members and Community: Continue to shape CardX and the Hypertension Management use case with committed CodeX members and input from the community at large.

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