Date:  2019-05-07

Quarter:  1 (Hosting Arden Syntax WG)

Chair:  Robert Jenders

Scribe:  Robert Jenders

Discussion

  1. Robert Jenders reviewed recent activity and ballot plans for the Arden Syntax WG as well as administrative tasks for the CDS WG (cds-intro-2019-05-07.ppt).
  2. To meet currency requirements as it had last been visited 2 years ago at the Madrid WGM, the WG reviewed, revised slightly and approved its Mission and Charter statement (mission-and-charter-cds-2019-05-07.docx).  Vote:  4/0/0.
    1. Action item:  Forward to the Clinical Steering Division for approval (Jenders - done).                    

Date:  2019-05-07

Quarter:  2 (Hosted by CQI WG; see their minutes for additional details)

Chair:  Floyd Eisenberg

Scribe:  Robert Jenders

Discussion

  1. Representation of Clinical Practice Guideline Recommendations in FHIR
    1. Bryn Rhodes reviewed progress on this project (CQF-Recommendations.pptx).
    2. Project work product:  Set of FHIR profiles and exemplars from various guidelines, with the goal of increased levels of structure and complexity.
    3. Use cases:  US CDC opioid prescribing guidelines; chronic disease management (CKD); HBV screening/immunization; prenatal care guidelines.
    4. https://build.fhir.org/ig/HL7/cqf-recommendations
  2. EBM on FHIR
    1. Brian Alper reviewed progress on this project, providing resources for describing evidence-based medicine recommendations.
    2. As part of this, Bryn Rhodes described work to create resources for cohort definition in the context of EBM (Cohort Definitions.pptx).  This includes a Group resource (a collection of entities that isn't an Organization = http://hl7.org/fhir/group.html.  Open discussion ensued regarding various attributes of these resources and associated data types, but no specific actions were undertaken.  Details of various use cases for instantiating the Group resource were entertained.  
    3. Next steps:  Continue discussion of use cases for these resources.
  3. Ballot Review
    1. Bryn Rhodes reported the results of the CQL ballot in the current cycle, which passed 52/8/58.  This included 103 affirmative comments and 44 negative ones, and review of these is in progress.
    2. Bryn Rhodes also reviewed the results of the CQL-based HQMF ballot, which also passed 59/4/45.  There were 219 affirmative comments and 19 negative ones, and review of these, too, is in progress.
  4. Clinical Reasoning Connectathon Report (Clinical Reasoning Connectathon 21 Report Out.pptx)
    1. Bryn Rhodes reported the CDS-related activity at the HL7 Connectathon this past weekend.  This included a successful events of colorectal cancer screening and blood pressure measure.
    2. Issues arising from this activity were reviewed.  This included the nuances of choosing dateTime vs Period; and references to the vitalsigns profile for processing of blood pressure in a setting in which only resources may be directly accessed. 
    3. Bryn Rhodes briefly reviewed the work of Claude Nanjo and others to create a new draft of the QUICK data model, including expressing opioid treatment recommendations using this draft version 3.0.0.

Date:  2019-05-07

Quarter:  3 (Hosting CQI WG)

Chair:  Bryn Rhodes

Scribe:  Robert Jenders

Discussion

  1. CDS Hooks Project Update (201905 CDS Hooks for CDS wg presentation.pptx)
    1. Isaac Vetter provided an update on activity regarding this project, including the Connectathon earlier in this WGM.
    2. All ballot comment resolutions have been implemented, and current content is being published as an HL7 STU => https://cds-hooks.hl7.org.  Latest version is at http://cds-hooks.org, where the hooks themselves are published, although the latter have not yet been balloted.
    3. The order-select hook is replacing the medication-prescribe hook, firing when a clinician kicks off order writing.  Similarly, order-sign will replace the order-review hook.
    4. The Connectathon experimented with SMART Web messages for data flow in implementing the CDS Hooks 1.0 specification, including CDS required for PAMA == Protecting Access to Medicare Act (USA) for radiology imaging ordering.
    5. Representatives of a number of companies with CDS applications and EHRs services participated.
    6. Next steps:  Publication of additional hooks; further use of SMART Web messaging; maturation of hooks.
    7. The WG discussed the distinction between the present CDS Hooks STU and balloting/handling of the actual hooks themselves (which are published separately).
    8. The WG discussed various aspects of creating an IG to include the patient-view hook so that it can be balloted and published with the CDS Hooks main specification, including whether it makes sense to create a distinct IG for each hook.  Consensus:  Defer further consideration to a conference call, possibly including the composition of a PSS.
  2. FHIRcast Project
    1. Isaac Vetter reviewed activity in this project (FHIRcast 201905.pptx).  FHIRcast is a JSON wrapper around FHIR resources that can be accessed by CDS apps invoked by a user.
    2. Specification at http://fhircast.org.
    3. Balloted in the current cycle, issues at https://github.com/HL7/fhircast/issues.

Date:  2019-05-07

Quarter:  4 

Chair:  Howard Strasberg

Scribe:  Robert Jenders

Discussion

  1. New Project for Balloting Specific Hooks for CDS Hooks
    1. The WG discussed various aspects of how definitions of specific hooks (e.g., patient-view) should be developed, balloted and published, including possibly leveraging the former project 1234 for CDS Hooks.  The consensus was to create a new PSS.
    2. The WG created a PSS to create 1 or more implementation guides to allow review, ballot and publication of specific hooks (HL7 CDS Hooks: Hook Definitions).
  2. EBM FHIR Proposals
    1. Brian Alper reviewed the details of the proposals in anticipation of further discussion and approval by the WG tomorrow.
    2. Proposals
      1. ComparativeEvidence => http://wiki.hl7.org/index.php?title=ComparativeEvidence_FHIR_Resource_Proposal.
      2. CohortSummary => http://wiki.hl7.org/index.php?title=CohortSummary_FHIR_Resource_Proposal
    3. Ballot is anticipated in the September, 2019 cycle.
    4. The WG approved these resources for inclusion in the next ballot.  Motion Alper, second Del Fiol.  Vote 4/0/0.