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CDS Development - Concept/Specification

2018 Person-Centered CDS Learning Network Annual Meeting Draft Agenda Posted

The preliminary agenda for the 2018 Person-Centered Clinical Decision Support Learning Network Annual Meeting October 15, 2018 is now available.  The day promises to be filled with information for all stakeholders including presentations from our keynote speakers, David W. Bates, MD, MSc, FACMI and Christopher Harle, PhD, MS. 

AMIA 2019 Symposium Panel: FHIRing up Evidence in CDS - Mobilizing Knowledge for Computable Guidelines in Patient Care

Add to Calendar 2019-11-18 15:30:00 2019-11-18 17:00:00 Atlantic/Azores AMIA 2019 Symposium Panel: FHIRing up Evidence in CDS - Mobilizing Knowledge for Computable Guidelines in Patient Care S25: Panel - FHIRing up Evidence in CDS: Mobilizing Knowledge for Computable Guidelines in Patient Care International Ballroom Center AMIA website: https://symposium2019.zerista.com/event/member/602069 Presenters: -Robert Greens, Arizona State University, Mayo Clinic -Maria Michaels, Centers for Disease Control and Prevention -Bryn Rhodes, Dynamic Content Group -Lisa Schilling, University of Colorado MM/DD/YYYY

S25: Panel - FHIRing up Evidence in CDS: Mobilizing Knowledge for Computable Guidelines in Patient Care
International Ballroom Center

AMIA website: https://symposium2019.zerista.com/event/member/602069

Presenters:
-Robert Greens, Arizona State University, Mayo Clinic
-Maria Michaels, Centers for Disease Control and Prevention
-Bryn Rhodes, Dynamic Content Group
-Lisa Schilling, University of Colorado

Event Date and Time

CDS/eCQM Harmonization

How are CDS & eCQM different?

Clinical Decision Support (CDS) and electronic Clinical Quality Measures (eCQMs) are closely related, share many common requirements, and support health care quality improvement. It’s important to also understand the differences between them and the efforts to help them work together (harmonize).

The standards used for the electronic representation of CDS and eCQM were initially developed separately and used different data models and computable expression languages. The use of different standards

  • Makes re-using or sharing machine readable logic between eCQMs and CDS rules very difficult
  • Creates a burden for health IT developers and those who provide technical support for implementation

Beginning with the eCQMs intended for implementation in calendar year 2019, Clinical Quality Language (CQL) - an Health Level Seven International (HL7) authoring language standard that provides the ability to express logic that is human readable yet structured enough for processing a query electronically—closes the gap on the differences between CDS and eCQMs.

Why harmonize CDS & eCQM?

Harmonization of CDS and eCQM standards will improve the ease of implementation. Harmonization will also make it easier to integrate and facilitate health IT enabled clinical quality improvement. Ultimately, the same or similar standards will be made and used to

  • Measure if appropriate care was given
  • Suggest care to providers and care teams when there are opportunities to improve care quality

Instead of developing a new standard that could be used for eCQMs and CDS, the focus is on

  • Modularizing or organizing the existing standards so they’re more flexible
  • Making common components that can be shared by both eCQMs and CDS

Who is harmonizing CDS & eCQM?

To learn more about this effort, please visit the HL7 Clinical Quality Framework (CQF) Wiki. CQF is an HL7 project led by CDS and Clinical Quality Information Work Groups to identify, develop, and harmonize standards that promote integration and reuse between CDS and eCQM.

The table below outlines the common areas and differing standards currently used in CDS and eCQMs.

  Patient and Clinical Data Computable Expression Logic Metadata and Structure Evaluation Model
CDS

Virtual Medical Record (vMR) for for V3-based CDS

QI Core (for FHIR-based CDS)

Clinical Quality Language

CDS Knowledge Artifact Implementation Guide

Decision Support Service

Decision Support Specification (DSS) for V3-based CDS

CDS Hooks (for FHIR-based CDS)

eCQM

Quality Data Model

Clinical Quality Language

Health Quality Measure Format

Quality Reporting Document Architecture

The strategy employed by the CQF initiative is to identify the common components used by each domain and define common standards for each of the core components.  

Common Shared Standards

Common Shared Standards

To date, these efforts have produced the following specifications for these common elements:

Common Metadata Standard:

HL7 Specification: Clinical Quality Common Metadata Conceptual Model, Release 1

Common Expression Logic Standard:

HL7 Cross-Paradigm Specification: Clinical Quality Language, Release 1 (CQL)

Common Data Model Standard:

HL7 FHIR Profile: Quality, Release 1 - US Realm (QI-Core)

QI-Core

QI Core Directory: http://hl7.org/fhir/us/qicore/history.html

QICore (Quality Improvement Core Framework) is a US Realm Implementation Guide of the FHIR Specification that defines a uniform way for quality measurement and decision support knowledge to refer to clinical data. The profiles align as much as possible with DAF and incorporate content from the (Quality Data Model) and the (Virtual Medical Record) specifications.

Current version: http://hl7.org/fhir/us/qicore/index.html
The QI Core Implementation Guide defines a set of FHIR profiles with extensions and bindings needed to create interoperable, quality-focused applications. The profiles in this implementation guide derive from and extend the US Core profiles to provide a common foundation for building, sharing, and evaluating knowledge artifacts across quality improvement efforts in the US Realm.
As an HL7 FHIR Implementation Guide, changes to this specification are managed by the sponsoring workgroup, Clinical Quality Information, and incorporated as part of the standard balloting process. The current roadmap follows closely behind the base FHIR roadmap, and the US Core Implementation Guide.

CQF and HL7® FHIR® 

HL7 FHIR® (Fast Healthcare Interoperability Resources) Specification is a standard for exchanging healthcare information electronically. The CQF initiative has developed various FHIR resources, profiles, and implementation guidance to represent quality measures and decision support artifacts. These resources are

  • Consistent with the Common Metadata Standard, and can use Clinical Quality Language (CQL) to represent expression logic, and the Quality Improvement Core Framework (QI-Core) profiles to represent clinical information.
  • Defined and introduced as part of the Clinical Reasoning Module of the Standard for Trial Use (STU) 3 version, currently STU 4, of the FHIR® standard. 
  • Being used and tested in a variety of settings including FHIR connectathons and ongoing pilots to validate that they can effectively fulfill the need for a single set of standards to support delivery of both decision support and quality measurement artifacts.

To learn more about this effort, please visit the Clinical Quality Framework github website.

Conference Announcement: Leveraging Patient-Centered Clinical Decision Support: Addressing the National Opioid Crisis and Beyond

On October 15, 2018, the Patient Centered Clinical Decision Support Learning Network (PCCDS-LN) is hosting a one-day conference to bring together diverse stakeholders to learn about and discuss key issues in drafting a National Opioid Action Plan. They will also set an agenda for developing, disseminating, and applying PCCDS in other domains. They invite you to please join them for this exciting event!

Free Training on AHRQ’s Clinical Decision Support Authoring Tool

Add to Calendar 2019-02-07 18:00:00 2019-02-07 19:30:00 Atlantic/Azores Free Training on AHRQ’s Clinical Decision Support Authoring Tool Registration is open for a webinar on Feb. 7 from 1 to 2:30 p.m. ET to provide training on AHRQ’s Clinical Decision Support (CSD) Authoring Tool, which can help develop interoperable, standards-based CDS via a user-friendly application. The tool is offered as part of the AHRQ-sponsored CDS Connect project, which demonstrates how evidence-based research can be more rapidly incorporated into clinical practice through interoperable decision support.Presenters will review the CDS Connect project and provide an authoring tool demonstration. This webinar is ideal for healthcare researchers, informaticists, individuals interested in developing standards-based CDS expressions, and other health IT professionals.WHO:Moderator:Edwin Lomotan, M.D., Medical Officer and Chief of Clinical Informatics, Center for Evidence and Practice Improvement at AHRQSpeakers:Sharon Sebastian, RN-BC, MS, CDS Connect Project Lead, MITREChris Moesel, CDS Connect Technical Lead, MITREWHEN: Thursday, February 7, 2019, 1 - 2:30 pm ET RSVP: Reserve your spot herePASS IT ALONG: All are welcome! Please forward this email to colleagues and share details of the webinar with your social networks.ADDITIONAL INFO: https://healthit.ahrq.gov/events/national-web-conference-clinical-decision-support-authoring-toolFOR ASSISTANCE: If you require special accommodations to participate in the web conference, please contact Amal Saeed at amal.saeed@conselara.com MM/DD/YYYY

Registration is open for a webinar on Feb. 7 from 1 to 2:30 p.m. ET to provide training on AHRQ’s Clinical Decision Support (CSD) Authoring Tool, which can help develop interoperable, standards-based CDS via a user-friendly application. The tool is offered as part of the AHRQ-sponsored CDS Connect project, which demonstrates how evidence-based research can be more rapidly incorporated into clinical practice through interoperable decision support.

Presenters will review the CDS Connect project and provide an authoring tool demonstration. This webinar is ideal for healthcare researchers, informaticists, individuals interested in developing standards-based CDS expressions, and other health IT professionals.

WHO:

Moderator:

  • Edwin Lomotan, M.D., Medical Officer and Chief of Clinical Informatics, Center for Evidence and Practice Improvement at AHRQ

Speakers:

  • Sharon Sebastian, RN-BC, MS, CDS Connect Project Lead, MITRE
  • Chris Moesel, CDS Connect Technical Lead, MITRE

WHEN: Thursday, February 7, 2019, 1 - 2:30 pm ET 

RSVP: Reserve your spot here

PASS IT ALONG: All are welcome! Please forward this email to colleagues and share details of the webinar with your social networks.

ADDITIONAL INFO: https://healthit.ahrq.gov/events/national-web-conference-clinical-decision-support-authoring-tool

FOR ASSISTANCE: If you require special accommodations to participate in the web conference, please contact Amal Saeed at amal.saeed@conselara.com

Event Date and Time