Council (CIIC) Providing a Shared Repository of Detailed Clinical - - PowerPoint PPT Presentation

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Council (CIIC) Providing a Shared Repository of Detailed Clinical - - PowerPoint PPT Presentation

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Clinical Information Interoperability Council (CIIC) Providing a Shared Repository of Detailed Clinical Models for all of Health and Healthcare NIH HCS Collaboratory and PCORnet December 1, 2017 Stanley M. Huff, MD W. Ed Hammond, PhD 1

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NIH HCS Collaboratory and PCORnet December 1, 2017 Stanley M. Huff, MD

  • W. Ed Hammond, PhD

Clinical Information Interoperability Council (CIIC) – Providing a Shared Repository of Detailed Clinical Models for all of Health and Healthcare

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Agenda

  • Why?
  • What we want to do
  • How?
  • Questions, comments, and discussion
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Why?

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Why?

“To help people live the healthiest lives possible.”

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Patient

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Core Assumptions

‘The complexity of modern medicine exceeds the

inherent limitations of the unaided human mind.’ ~ David M. Eddy, MD, Ph.D. ‘... man is not perfectible. There are limits to man’s capabilities as an information processor that assure the occurrence of random errors in his activities.’ ~ Clement J. McDonald, MD

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Eileen

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Why?

  • We need to
  • Provide better care
  • By sharing executable clinical decision support modules
  • Decrease cost
  • By providing better care
  • By eliminating point-to-point mapping of data elements
  • Make clinicians and patients happier
  • Provide accurate computable data as the foundation of a

learning health system (LHS)

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What we want to do

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What

  • We want to create ubiquitous sharing of standardized data across the

breadth of medicine for:

  • Direct patient care
  • Patient entered data and outcomes
  • Research and learning
  • Public health
  • Clinical trials
  • Data from devices
  • Post market surveillance
  • Quality and disease specific registries
  • Billing and health administration
  • Any where that we share health related data and information …..
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Make a shared repository of Detailed Clinical Models (aka a logical models)

data 138 mmHg SystolicBP SystolicBPObs quals data Right Arm BodyLocation BodyLocation data Sitting PatientPosition PatientPosition

SNOMED CT LOINC or SNOMED Observable 11

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What

The models are used during software development, which makes the process much faster and more efficient, and it insures that the references to data in the software adhere to the agreed standards.

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data 138 mmHg SystolicBP SystolicBPObs quals data Right Arm BodyLocation BodyLocation data Sitting PatientPosition PatientPosition

SNOMED CT LOINC or SNOMED Observable

HL7 CDA CDISC HL7 FHIR Repository of Shared Models in an approved Formalism Model Review

SNOMED CT LOINC RxNorm Core Reference Model

Standards Infusion

CEMs

Initial Loading of Repository

DCMs CDA Templates

  • penEHR

Archetypes ISO EN 13606 Archetypes FHIM Models FHIR Resources

Logical Model Development Lifecycle Model Dissemination

Translators HL7 V2 NCPDP X12

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The Interoperable App Development Process

Project Needs

  • Pediatric Growth Chart
  • Neonatal Bilirubin
  • Comm Acq Pneumonia
  • OPA Data Collection
  • MQIP
  • ACC registries

Terminology Server (SOLOR) Domain Analysis Create Logical Models (CIMI) Approve Models

Model Repository

Create Physical Artifacts (FHIR

Profiles)

Artifact Repository

(FHIR Profiles)

Create Software

(Apps, Services, CDS) Conformance Testing
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The ultimate value of detailed information models

  • Software is developed much faster
  • Clinical knowledge is contained in the models
  • Much easier for software engineers
  • The data used in the applications is completely conformant to

standards, leading to semantic interoperability

  • If you follow the SMART on FHIR development strategy, your

software can be shared with any system that supports the approved standards

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Three related but very different questions

  • What data should be collected? (part of domain analysis)
  • It will be different for different situations
  • How should the data be modelled?
  • Two fields or one (the degree of pre and post coordination)
  • What does the data mean?
  • How do we make computable definitions for diabetes mellitus,

myocardial infarction, heart failure, chronic renal failure, etc.

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How?

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How

  • All stakeholders agree to work together
  • Have practicing front-line clinicians direct the work
  • Capitalize on the work in existing projects
  • Agree to use a common format for representing the models
  • Use and share common tools to create the models
  • Share the models through an open internet accessible repository
  • Approve one preferred model for a given kind of data in a given situation
  • Use existing models whenever possible
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CIIC 2017

Meeting Overview July 13, 2017

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Summary of the July 13th meeting in Bethesda

  • Keynote speaker – Don Rucker, MD (National Coordinator for HIT)
  • About 120 attendees
  • Representing – AAN, AAO, ACOG, ACS, ACC, ACP, APTA, ANA, FDA, CDC, NCI,

AHRQ, NIAID, DoD, VA, PCPI, AMIA, SPM, HIMSS and many other organizations

  • Meeting outcomes
  • CIIC should continue
  • Create mission, vision, a plan for initial governance
  • Develop a mailing list and a discussion forum
  • Projects
  • ACOG – OPA – FPAR, Cancer DTR, MDEpiNet RAPID, Vital Signs, Skin and Wound Assessment,

PCPI Registries on FHIR, …

  • Upcoming meetings
  • December 5-7 in New Orleans with HL7 Partners in Interoperability
  • January 10-12 at LDS Hospital in Salt Lake City
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The END (or maybe the beginning?)

Contact Information: Stan.Huff@imail.org

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