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Produce Guidance (See this CoP page)

Make Guidance Computable (See this CoP page)

Current 

Approach

  • Using the Agile Approach to CPG Development (inclusive of Integrated Process) to concurrently Produce Guidance and Make Guidance Computable in Agile CPG Team (C19 DGWG)
Pearls/Tips Learned/Tools
  • getting variables coded/mapped is key but time consuming (UMN)

Approach Used by C19 DGWG

  • Using CPG-on-FHIR standard for representing/ expressing the full intent of the Guidance in computer-interpretable artifacts (part of HL7 CPG-IG)
  • Using the Agile Approach to CPG Development (inclusive of Integrated Process) to concurrently Produce Guidance and Make Guidance Computable (part of HL7 CPG-IG)
  • Use Agile Knowledge Engineering methods, principles, and tools
    • Cross-functional Integrated team (Agile CPG Team)
    • Leverage composite nature of CPGs (e.g. can develop logic for inferences on patient information- CPG_CaseFeatures) to build incrementally and iteratively with rapid feedback
    • Pull knowledge engineers into Content design/reviews; pull domain SMEs into knowledge representation design/reviews
  • Leverage CPG-on-FHIR as a faithful expression of Guidance and its ability to create computationally derived CDS and Cognitive Support, patient-specific, practice-level digital Quality Measures/Metrics, eCaseReports, etc. to create computable artifacts used downstream in the Learning Health System and to provide closed-loop feedback/feedforward.
  • Leverage established tools and capabilities (e.g. BPM+ process and tooling, Clinical Ontology) to author computable Guidance and Open Source tooling to translated into HL7 CPG-on-FHIR to leverage derivative and native compute

Additional Pearls from C19DGWG

  • Engage consumers/ users early and often
  • Engage downstream vendors (e.g Terminology vendor USED in the EHRs) early
  • Just because everyone everyone is using the same terminology systems doesn't mean they're agreeing how to use the actual terms- this needs to be considered and addressed to make ecosystem/supply chain work properly (feedforward from Evidence, but also feedback of data semantics back into evidence)
  • Learn from related communities of practice (e.g. Agile Software Engineering)
Desired Approach
  • Harmonize latest evidence from multiple sources and serve/push the guidance to partnered HCCNs (NACHC)
  • Seamless collaboration of clinical stakeholders to determine best practice approach in a constantly evolving environment; More asynchronous work processes to optimize efficiency (ACEP/EC)

From C19DGWG

  • Build computable artifacts/assets on Real-World data to enable better design/ specification and Test-driven Development (Agile)
  • Leverage mature Knowledge Base to implement Knowledge Architecture (e.g. CPG profiles) and design, develop, test, maintain, and reuse artifacts/ assets
  • Concurrent Validation and Development using above

Others

  • better mapping approaches/collaboration with terminology vendors to speed mapping (UMN)
  • Pull together multiple fit-for-purpose standards addressing the whole stack: BPM+, SNOMED, FHIR, ANF (VA)
  • Interoperable format leveraging CPG-on-FHIR (working with C19 digital guideline WG on this) (UMN)


Needs to Achieve Desired Approach

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Other [Details:]

  • Better collaboration structure to bring parties together consistently (ACEP/EC)

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

  • Collectively Improve data dictionary for prospective use case: collect patient-level COVID-19 data (NACHC)

__Other [Details:]

Support We Can Provide Other Participants
  • Engagement with ACEP’s group of clinical expert (ACEP/EC)
  • Data dictionary development (NACHC)

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