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HL7 vMR for CDS Project Update HL Atlanta – September 2007

HL7 vMR for CDS Project Update HL Atlanta – September 2007. Robert Dunlop, MD Director, Clinical Development InferMed UK +44-20-7291-7410 robert.dunlop@infermed.com http://www.infermed.com. Barbara McKinnon McKinnon Associates Inc. Project Lead: HL7 GELLO &

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HL7 vMR for CDS Project Update HL Atlanta – September 2007

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  1. HL7 vMR for CDS Project Update HL Atlanta – September 2007 Robert Dunlop, MD Director, Clinical Development InferMed UK +44-20-7291-7410 robert.dunlop@infermed.com http://www.infermed.com Barbara McKinnon McKinnon Associates Inc. Project Lead: HL7 GELLO & Virtual Medical Record (vMR) Projects (O) 610-644-5245 (M) 484-883-6927 bmm15@comcast.net

  2. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 2 Discussion Topics • vMR Project: • HL7 Project Approval • Business Use Cases: • Breast Cancer with Genetic Extension • BUC Issues • Next Steps

  3. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 3 vMR Project Scope A Virtual Medical Record (vMR) is a data model, based on the HL7 RIM format, for representing clinical information inputs and outputs to/from clinical decision support services. Data is exchanged with local clinical information systems at the point of care, through a software middleware layer that translates the data into a standardized vMR format.

  4. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 4 vMR Project Scope – Highlighted in Yellow

  5. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 5 vMR Project Goal The goal of this project is to create an HL7 vMR data model recommendationand implementation guide, based on the HL7 V. 3 RIM, which is capable of supporting clinical decision support (CDS) for “chronic disease management” at the point of care.

  6. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 6 vMR Project Deliverables & Timeline

  7. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 7 vMR Project Timeline

  8. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 8 vMR Project Outreach • Extensive outreach done prior to finalizing project scope. • HL7 Board Members, Technical Steering Committee, Infrastructure & Modeling, RCRIM, UK Affiliate, Patient Care. • AHRQ, CDISC, DoD, NCI, VA. • Will continue to provide periodic updates to interested parties who cannot attend HL7.

  9. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 9 vMR Project AlignmentsIdentified to Date

  10. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 10 HL7 vMR Project Approvals • HL7 Project Management Office (PMO). • HL7 Architectural Review Board (ARB).

  11. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 11 vMR Business Use Cases • The project team will define 4 initial business use • cases, including storyboard, activity diagram, and • specification model: • Breast Cancer with Genetic Extension (in progress) • Diabetes Type 2 (in progress) • Asymptomatic Brain Aneurism • Hypertension • Other business use cases will be developed with approval • of CDS work group and if resources are available to • develop required HL7 project materials.

  12. vMR Breast Cancer BUC

  13. vMR Breast Cancer BUC

  14. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 14 vMR BUC Issues • How to represent CDS Service Determination “pros” and “cons”; both encoded and narrative text. • Re-interpretation of patient genetic profile as data elements are updated in EHR, including how re-interpretation will be initiated: auto-generated via EHR or CDS Service, or person-initiated via EHR; and how patient consent will be obtained. • Need for knowledge databases of: • DNA variations (or variant combinations). • Coded clinical significance: Unknown Significance to Pathogenic or Benign. The system receiving notification of the change might then propagate this information, flagging records for re-evaluation.

  15. HL7 Atlanta – 9/07 Virtual Medical Record (vMR) for Clinical Decision Support (CDS) 15 vMR Project - Next Steps • Set up more formal lines of communication to aligned HL7 TC’s and SIG’s. • Evaluate alignment to other projects. i.e. US HIT ONC Personalized Health & HL7 RCRIM/CDISC ASPIRE Project. • Evaluate alignment to CEN vMR. • Continue business use case development. • Project update at HL7 San Antonio, TX (1/07).

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