Solution Architecture v1

Owned by Dave Carlson
Last updated: Sept 30, 2020
2 min read

This solution architecture describes how the combined use of OMG BPM+ and HL7 FHIR standards contribute to functional requirements for patient-centered care management. These architectural components are described independently of OMG and HL7 standards, then the implementation guide (IG) includes specific recommendations and implementer guidance for using available standards to fulfill this reference architecture.

Continuous Patient Assessment

  • Evaluate status of a patient’s care based on events and patient-reported outcomes from the Clinical Data Store.

  • Care Pathway Manager may recommend assessment instruments for additional evaluation of a patient’s progress toward goals included in their care plan.

  • Clinical decision support produces recommendations to update a patient’s existing care plan based on pathways and assessments.

Care Pathway Manager

  • Discover applicable guideline recommendations and care pathways for a patient’s condition(s).

  • Evaluate pathways, produce patient-specific actions and order sets used by the Patient Care Manager.

Patient Care Manager

The Patient Care Manager requirements in this solution architecture are aligned with description of eCare Plans in the AHRQ evidence-based Care Transformation (ACTS) Roadmap. The Patient Care Manager produces a proposed care plan template, based on guideline recommendations and a patient’s current clinical data. A clinician would then customize that care plan template to create a personalized care plan that is specific to the patient’s needs, including consideration of social risks and personal preferences. The resulting care plan would be shared with all participants in the patient’s care team, including community providers and the patient.

Clinical Reasoning

  • Supports decision services and execution of logic for use by other components.

  • Requires use of computable, standards-based representation for logic and clinical reasoning services.

Clinical Practice Guideline (CPG) and Pathway Repository

  • Search repository for applicable guidelines and pathways using SNOMED CT codes for patient conditions.

  • Retrieve guideline artifacts in computable format for use in the Care Pathway Manager, or for execution of guideline recommendation rules in the Clinical Reasoning component.

Clinical Data Store

  • Aggregate and provide access to a patient’s complete clinical record via standards-based API services.