| Technical Capability | Functionality | Collaborations | Responsibilities | MVP Priority | Existing Component | Existing Resources | Description | Preserve Concept? | Code Worth Keeping? | Coordinators | Questions |
| Terminology Management | Provides terminology / value set definition and management capabilities, including translation mappings between different vocabularies. Scope includes semantic reasoning using description logic such as subsumption. | Ontologies Databases | Maintains reference terminology relationships Lookup Translations between vocabularies Subsumption/equivalence Realtime response | Low | CTS2 Semantic Terminology Server | No applicable open source equivalent | Terminology mapping tools & technologies Semi-structured parsing Alignment (model, terms) Entity extraction | Yes | Yes with significant refactoring | Claude | |
| Rule-Based Reasoning | Provides reasoning capabilities based on traditional production rules. | Fact Base Logical Model | High | Framework | Drools/Guvnor/KIE | Issues with KIE stability and performance | Yes | Esteban | |||
| Decision Support Invocation | Provides intelligent CDS invocation and request routing to one or more different reasoning services. Manages metadata potentially important to the invocation such as intent/goal, clinical context, requestor role, etc. | Reasoning Environment Management State Management Work Product management | Route Reasoning Reasoning Environment Setup Result Hand-off | Low | Services | OpenCDS-DSS eHM Invocation Framework Decision Support Agent | Coordination with CDS-on-FHIR team What version? | Yes | ASMR code base that needs to be repackaged under Socratic Grid | Jerry Esteban | |
| "Event" Source Management | Provides the functional ability to respond to "events" within the environment, including messages, application events, scheduled evaluations, and features identified in data streams. | Decision Support Invocation Event Publish and Subscribe | Manage Event Source Integration Act as EPS Publisher | High | Framework | Mirth Fusion | Yes | Yes | Esteban Jerry | ||
| Clinical Data Repository | Provides a repository of clinical data that can be used for demonstrations, rule/workflow validation, development, etc. | Provide data for testing Provide data for demonstration Allow data to be added/edited | High | Repositories | FHIRBase | Yes | Evaluate | Claude | Should thiis component be capable of time shifting all data returned? | ||
| User Interaction Patterns | Provides capabilities for integrating CDS work product into clinical UIs. Approaches might include complete applications, portlets, widgets, or other components for desktop or mobile clients. | High | Framework | Yes | Evaluate | Claude | |||||
| GUI Frameworks | Provides a consistent and re-usable framework for building client GUIs and visual interfaces. | KMR Portal CareWeb SMART on FHIR Portal? HSPC | |||||||||
| Transformation Capabilities | Provides capabilities for transforming data between different HL7 data models, including FHIR, vMR, CDA and FHIM. Might be implemented as a set of librabries and/or exposed as a service. | Terminology Management | Structurally Transform Content Translate Terms Validate Data | Medium | Services | Mirth Open Health Tools MDHT ken lord | Yes | Yes | Jerry | ||
| General Security | Provides reliable, role-based access control to services and components within the environment. | Fine grained access control Decision Support Invocation | High | Framework | OAuth /OAuth2 | Yes | No | Jerry | Do we want a delegate model here? | ||
| Application SDKs (plugable functional façades etc) | Provides a consistent and well organized set of APIs for application developers - abstracts the complexity of midtier services and renders structured data into a human- readable format. Allows developers to "plugin" new application specific components and functional behavior. For example, provides a standard FHIR API with a plugin to handle profile management. | Low | Services | Yes | Evaluate | Claude | |||||
| Data Source Integration Framework | Provides specific integration plugins to vendor EHR platforms such as Epic and Cerner. For example, components that bin as well. to existing EMR interfaces OR a component that registers interest in EMR events/messages. Not restricted solely to clinical information, but might include configuration or administration data. | Transformation | Access Vendor data Access Vendor events | High | Services | Yes | Evaluate | Amnon | |||
| Logical Model | Provides a clean information model for organizing and representing clinical data in a semantically precise, logically consistent way that is optimized for CDS and Quality Measures. | Transformation | Provide a consistent easy to use model for reasoning | High | Models, Terminologies & Value Sets | Yes | Yes | Claude | |||
| Canonical Data Model | Provides a clean and consistent instance representation that enhances, non-inference secondary use, fro example, reporting, transport, auditing, etc. | ||||||||||
| Communications Framework | Provides standardized functionality for communicating between parties (machine and/or human), i.e delivering alerts, recommendations, and other communications acts using a variety of transport mechanisms to include, but not limited to, email, Short Message Service (SMS), VOIP, or Instant Messaging (IM). | Transport Plugins Requesting System | Provide System to Human Communication Escalation and Routing? | Low | Services | UCS reference implementation | Yes | Yes | Esteban Amnon | What scope of the SFM are we addressing here? | |
| Knowledge Artifact Persistence (stores) | Provides a central, secure repository for storing knowledge artifacts during development and governance, and then as source of runtime knowledge bases during deployment. Also includes persistence of canonical informational models, and/or pointers to non-standard information models. | Low | Repositories | KIE KMR | Need to think about registries for shared resources. | ||||||
| Healthcare Settings/Resources Registries | Provides registries and repositories of metadata, equipment, inventories, facility and other resources that define the context and settings in which and by which care is delivered. Provides data about local availability of material and human resources. | Low | Repositories | TBD | Need to think about registries for shared resources. Formularies, Service inventories, etc... | ||||||
| Work Product Repository | Provides a configurable, potentially centralized store for CDS work product (recommendations, alerts, orders, tasks, etc.) that ensures the necessary level of durability and availability to support both reference and transactional use cases. | Work Product Management | Work Product CRUD | High | Repositories | Work product lifecycle management | ASMR code base that needs to be repackaged under Socratic Grid | Jerry Esteban | |||
| Work Product Management | Provides the essential services for the management of generated work product. This include the essential CRUD services, assignment, reassignment, status update, suppression etc. | Work Product Repository | Retain Work Product State Retain User specific information relating to the Work Product Provide a audit trail of work product actions. Help avoid duplication | High | Services Framework | Service to support Work Product management activities, e,g, view of work products,assignments, events on work products [e.g. read, supress]. | |||||
| Metrics and Feedback Management | Provides facilities to collect a variety of CDS system and performance metrics including what rules are fired, what advice was given, whether advice was followed, how long the analysis took, etc. | Low | Framework | ASMR code base that needs to be repackaged under Socratic Grid | Jerry Esteban | ||||||
| Predictive Analytics | Provides predictive analytics and other non-rule based reasoning capabilities. | Low | Services | ||||||||
| Complex Event Processing | Provides for performant consumption, analysis, and feature extraction for medical device data and other sources of high volume data. Ensures effective communication of evidentiary data for storage and alerting. | Low | waveform information can be provided in a number of forms: snapshots, continuous "real-time" stream. Independent of the form of waveform. it accommodates additional metadata (Type, Rate, Time….) | IHE-WCM Profile | |||||||
| Access Control, Security, and Compliance | Provides capabilities for enforcing patient, provider or organizational policies regarding the access, visualization, or use of clinical data. | Work Product Management Transformation Services Event Pub/Sub | Redaction and Info Access | Low | Framework | Duane's framework | Security labeling/Policy enforcement EP | ||||
| State Persistence & Retrieval | Provides facilities for managing the persistence and retrieval of state in support of the reasoning environment. | Reasoning System Decision Support Invocation | Capture Process State Restore Process State Capture Fact State Restore Fact State | Low | Framework | Drools platform | Must fully expose workflow. Requires needed expressivity. Support multitenancy. Performant and scalable. | Yes | Evaluate | Jerry | |
| Reasoning Environment Management | Provides provisioning, configuration and monitoring capabilities for the core CDS framework environment. Provides session management, knowledge base deployment, "fact" caches, data queries etc. | Medium | Framework | (DSA) and other 'profiler' functionality. | How to configure a dynamic patient-based tool and manage that session flexibly - loading/unloading rules within given clinical context. Patient, provider, facility-specific sessions/customizations, etc... | Infrastructure to manage reasoning, including trigger based reasoning, longer term fact environments, data querie etc. | |||||
| Knowledge Artifact Authoring | Provides graphical authoring and governance tools specifically targeted to the non-technical domain expert, allowing them to author standards-based artifacts tht can be translated into runtime code. | Medium | Authoring | Enhanced Clinical Editor Assertion Editor KIE HeD Editor | Need to define what is the scope of this: - HeD Artifacts? - Guidelines? - Workflows? | HeD Decision Modeling Notation (DMN) BPMN API4KB | |||||
| Knowledge Governance, Configuration, Utilization, etc | Reasoning Environment Management | Medium | Framework | KIE | ASMR code base that needs to be repackaged under Socratic Grid | Jerry | |||||
| Event Publish and Subscribe | Provides pub-sub, topic management, and content intervention capabilities important for managing SOA at scale. | "Event" Source Management | Support Pub/Sub Message Delivery Mange Topic Trees | Medium | Services | EPS reference implementation | Need to begin open source community. Need to move from prototype to production grade library. | EPS | |||
| Classification Capabilities | Leverages predictive analytics, rule and non-rule based reasoning capabilities to facilitate the classification of patients into one or more clinical or administrative cohorts. This is an essential feature for population health programs or for assessing patient risk/prognoses. | Cohort Management | Identify potential membership in a cohort | Low | Cohort Service | Yes | Yes | Andrew Jonathan | |||
| Cohort Management | Provides services for managing cohorts, e.g. manually adding or removing patients from disease registries, confirming set membership, cohort maintenance. | Classification Capabilities | |||||||||
| Entity Identification | Identifies whether there is an individual patient matching demographic search criteria (e.g., name, gender, date of birth). Also may be applied to identify other entities such as healthcare providers or facilities. Answers the question...are n things the same , different, or maybe/partially the same. Also...what is the canonical id of this thing? | Entity Base OpenMPI | Low | Services | IXS | Needs careful discusssion regarding overlap with Cohort service and resource registries | |||||
| Order Management | Provides a consistent, structured methodology for ordering a variety of services and products, including, but not limited to, pharmacy, nutrition, radiology, and laboratory items. For knowledge artifact and orderable catalog management see Knowledge Artifact Store below. | Order Fulfillment | Manage Order Lifecycle | Low | Services | OS reference implementation | Not sure of use cases at this time | Yes | Yes | Claude | |
| Order Fulfillment | Provides a consistent, structured methodology for communicating effectively with ordering services regarding the fulfillment of a variety of services and products. | Order Management | Support Order fulfillment Coordinate with Order Management | Low | Services | Yes | No | Claude | |||
| Unstructured Data Management | Provides capabilities for extracting structured or semi-structured data from unstructured sources such as free text documents, images, or waveforms. | Low | Tools | UIMA with plugins? | |||||||
| Data Generation | Provides capabilities for producing clinical data, values, distributions, etc. that are appropriate for specific use cases. Provides ability to declaratively generate potentially millions of data instances in RDF or FHIR formats for testing and demonstration purposes. Also includes ability to derive anonymous or de-identified instances from actual source data using a variety of sampling criteria. | Generate Representative data for Demonstration Generate Representative data for Testing | High | Tools | Prototype | Should also include event streams | |||||
| Expression Syntax Translation | Provides for pluggable components that offer the ability to translate various rule and expression syntaxes into runtime code, for example, those written in CQL into the corresponding Drools DRL. | Low | Tools | Prototype | |||||||
| Data Query Mediation | Provides capabilities to locate, query, and manage the retrieval of clinical and administrative data from distributed and/or heterogenous sources. Typically these queries will be patient centric, but the scope also includes population queries where the query key is not a patient id, for example a disease or lab. | Low | Supports retrospective query of PCD data from databases. Supports Use Cases such as Clinical Decision Support | IHE-WCM Profile | |||||||
| Optimization/Planning | Provides reasoning capabilities specific to planning or optimization tasks. | Low | TAP-Resource Capacity Simulator | ||||||||
| Reporting & Business Intelligence | Provides canned, ad hoc, or parameterized reporting and other traditional BI analysis capabilities. | Medium | TAP-Spago Integration | ||||||||
| Evidence / Reference / Educational Content Delivery | Provides information (links, references, actual articles) to sources of reliable evidentiary material for justifying CDS advice, meeting meaningful use requirements, or providing "help" content using a variety of orthogonal concerns, e.g. if a provider is dyslexic, visually impaired, etc. | Curate Content Deliver Content | Low | Infobutton resource providers, IB clients and libraries. | Infobutton? | ||||||
| Task Management | Provides for the management and state monitoring of "tasks", including human tasks. Provides a tasking model of discrete building blocks that can be used to define higher level compositions. | Task Initiation Task Status review Task Update and Control | Medium | Services | |||||||
| Common libraries and tooling | Certain functionality is 'cross-cutting' and can be pulled out into common libraries that need to be carefully managed. This may include libraries for logging, security, etc... | Framework | KMS/OpenCDS |
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