Data Management

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Simple Sandbox Patient Data

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Manager #tool

• User can see all the data associated with the patient visually (including revision history)
• User can add, modify, or delete data associated with a patient
• User can create a patient
• User searches for resources by code, date, profile(?)
• Terminology Server plugged in to validate and assist in selecting values (see clinFHIR as an example)
• User can create resources based on a profile

Simple Data SecuritySecurity 

• User can only see their data
• User can only modify their data

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• User can load and build sharable data sets

Enterprise Quality Data

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Set #content #data

Data set representative of one or more actual enterprise EHRs

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• App provides advice based on current threshold
• App gets live updates when new values arrive in the underlying EHRCDS EHR
• OpenCDS Uses (U of U)
  • Application makes a call to Decision Support and gets immediate feedback
• CDS Hooks Use Cases
  • When user opens app, if one of the following conditions is met, a CDS Hooks Card is shown:
    • Patient doesn't have TcB or a TSB observation for patient after a certain time limit
    • Bili Count Values exceed a certain threshold

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• Monitor sends alerts based on decision support rules
• Uses rules published in a Knowledge Management system

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Care Coordination Scheduler

• Allows a Care Coordinator (FHIR - Practitioner) to manage schedules for a Patient
  • Phase 1: 

    Jira Legacy
    server JIRA (healthservices.atlassian.net) serverId 0c1a6aa0-7b53-3201-966d-55c7845f4db9 key HRI-452

Clinical Data Models and Definitions

Logical Models

• Tools to help developers create applications that are based on logical clinical models and accepted medical terminology concepts. 

Structural Models (Profiles)

• Validation of data based on profiles

  • Need to engage Graham, James, and Tom on finalizing specification for validation rules and error handling.

  • Validation can potentially happen client side, server side or by third party.

  • Validation constraints (e.g. profiles) can be provided by client, server or third party 

• Visual Tools to create data based on a profile

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Eventing and Publish/

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Subscribe

FHIR Subscription (aka "Trigger") Support #feature

• Pattern Matching
  • Supporting the FHIR "search" framework / query language in a reactive sense
• (Re)action
  • Websocket
  • REST
  hook 
• email
• sms
• message
  • hook - posting an event payload to a specific endpoint
  • External communication - email, sms
  • FHIR message - publishing an event (or invoking an operation?)

CDS Hooks Support

Build in support for CDS Hooks into FHIR Starter (or whatever Mock-EHR HSPC ends up using in the sandbox).

EHR

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Event Models #content

• Support for a common set of logical Clinical and Administrative events generated by the EHR. E.g. ADT

Communication

Alerts & Notifications

• Common way to raise alerts and notifications from an app/svc external of the EHR

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Logical Clinical Model Application Development Tools

Tools to help developers create applications that are based on logical clinical models and accepted medical terminology concepts.

Knowledge Authoring Tools

Model Authoring IDE

Tool to create logical clinical models and then generate FHIR profiles.

Terminology Authoring IDE

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Terminology Management

Terminology Support

• Coding resolution to retrieve concepts and their descriptions
• Resolve relationships between concepts
• Resolve valuesets

Terminology Server

• Exposing the terminology capabilities as a service

Terminology Authoring Tool

• Enable the creation, maintenance and versioning of coded concepts, terms, valuesets and mappings

Conformance Testing Tools & Framework

Tools to test the conformance of applications, knowledge, and services against the HSPC specification.

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It still needs to be determined what it means to be an HSPC compliant application.

Integration Libraries

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Client

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Integration

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• Java - integration library for the rapid development of

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C# Client Library

Integration library (similar to the java client library) to enable rapid development of C# based applications.

HSPC App Store

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• Java applications
• Android - 
• C# - 
• Python -

EHR Platform Integration Libraries

• Epic, Cerner, Athena, etc..

HSPC Marketplace

Marketplace for Application, Platform, and Knowledge Asset Developers to showcase and sell their HSPC compliant applicationsitems.

Knowledge Management Frameworks & Tools

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• Profiles
• CDS Rules
• Workflows
• etc.

March 2016 Brainstorming Session

Sandbox Manager

• Sandbox Manager Supports mulit-institution use cases
• User can configure sandbox to connect to external FHIR server
• Sandbox multi-tenancy
• Support launch scenarios for 'Related To' personas (e.g. parent launches app to look at child's data).
• Sandbox user populates their sandbox w/starter data set
• A sandbox user resets their data set
• The default/demo sandbox "cleans/resets" to base dataset
• User's of the sandbox can do bulk imports of data
• Clinical Timeline Data Simulator
  • A user can create a time based clinical scenario to play so that data flows into their sandbox on their defined timeline to simulate clinical data scenarios.
• A user of the sandbox can use JSFiddle to realtime query and build apps from within the sandbox manager.
• A user of the Sandbox manager can self register their application and make it visible in the HSPC App Gallery.
• Multiple users can be associated with a single sandbox
  • An admin can assign sandbox management permission to their users (e.g. can create data? delete? add users?...)
• A single user can be associated to multiple sandboxes.
• Sandbox user can create, modify, delete, and configure these resources:
  • Locations
  • Organizations
  • Healthcare Services
  • Provider Roles
  • Encounter
• Need marketing and visually appealing front page with simple explanation of sandbox and encourages people to sign up.

Reference Implementation

• Terminology Services
• A user of the reference impl uses either docker or a simple command line command to instantiate a full and working version of the reference implementation.

Documentation

• More user friendly 'For Developers' section
  • linear, tutorials, pictures/infographs

FHIR Profile Support

• Profile Browser
  • A dev searches for a profile and uses simplified information to determine which one would be appropriate for their use case and then uses the profile details view to explore and learn about how to appropriately and programmatically interact with the profile.
  • A user of the profile browser would live query the sandbox using the profile and JSFiddle.
• HSPC FHIR Profile Repository
• HSPC Profile Review & Feedback tooling

Patient Data Manger

• Support all the Common Clinical Data Set (MU3): https://www.healthit.gov/sites/default/files/commonclinicaldataset_ml_11-4-15.pdf

Appointments and Workflow

• Schedule Appointments (Support in the app and the refrence impl)
• True multi-organization query of apps (like HiMSS demo, but with security and patient reconciliation)

HSPC App Gallery & Marketplace

• Need to flesh this out... consider competing on the ONC challenge grant: https://www.healthit.gov/techlab/innovation/connecting-accelerating-fhir-app-ecosystem

Priorities

• Profile Browser/Discorvery
• Clinical Data Scenario Builder
• Documentation
• Data Cloning, export, import, reset, management
• Eventing
• Docker/easy download run, and config