Korábbi változatok

• Includes gathering the data that will be analyzed within and across care delivery organizations. A common reference architecture (a template or blueprint from moving data from one system to another) will help ensure that the data can be combined in meaningful ways. The standards and data harmonization initiatives mentioned below should be used with this reference architecture.
• 'Results' include 'lagging indicators' such as clinical outcomes. Analyzing/addressing 'leading indicators' (e.g., process changes) is addressed under "Implement Guidance"

• ' (e.g., process changes) is addressed under "Implement Guidance"
• (add something explaining what we mean by 'analyze' - e.g., leveraging machine learning/AI, etc.)

• CPG on FHIR: describes how computable guidelines can be used to get data out of EHRs for reporting to registries, health plans, CMS using FHIR (see especially Approach section)
• MedMorph IG draft (see this page - workflows for how to extract/share data from EHRs to endpoints such as public health agencies and research organizations)
• Use BPM+ as a standardized way to model workflow and processes; we know how to generate evidence in a standard way; we need to share this knowledge so it can be put into practice in LHS cycle, These processes can all be represented in standard way (BPM+). This will help us be more effective at deploying knowledge in practice. Easier for those in front line to understand and implement guidance. WHO looking at using BPM in developing their L2 artifacts that they use CQL to ultimately express.
• There is a Tiger Team working to implement the best that BPM+ offers for workflow modeling with what CPG on FHIR offer for decision modeling. Create an 'uber standard'
• DEQM FHIR IG does similar things to what MedMorph does but focuses on quality reporting. Focused initially on data exchange for quality reporting, but now looking at other use cases, e.g., med reconciliation. Parallel with MedMorph, which focuses more on public health perspectives - and is therefore more robust/expansive in scope. These initiatives are communicating to support how to get FHIR data from EHRs to various different consumers.
• Pay attention to data quality (details to come); need think about harmonized data quality terminology framework; 3/3 guideline for secondary use of data from EHRs
  • pilot of MedMorph architecture planned for March 21. Will explore whether more specific criteria for sending and receiving data can help improve data quality.
• ODHSI: data harmonization and the use of data from different systems in a commonly understandable an informative method. (have outstanding data quality dashboard)
• ACEP/EvidenceCare ED Severity project used CPG on FHIR, so that is a good use case for addressing this part of the cycle. Likewise for UMN work on anticoagulation. (NACHC using CPG on FHIR and MedMorph as part of addressing the full ecosystem cycle for Hepatitis B/C and HIV).

• Curate data into a structured, centralized resource - applying specific instructions about how to obtain and document the data (historically a manual process to locate information but becoming more automated)
  • Need semantic interoperability so that results can be aggregated/compared across CDOs; should be based on widely used, open data and standards
• Put information into registry (institution-specific or cross-institution)
• Generate report - to get feedback about effectiveness, safety, etc. of various interventions

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Regarding Value Sets recommend the following process (applies to anticoagulation, testing/triage, vaccines, steroids, and any other topic):

1. Take inventory of what value sets you’ll need (be specific)
2. Check Alliance website or Value Set Authority Center (VSAC), we might have already published some of them among the 600+ value sets
3. If certain value sets are not present or you are unsure, contact Victor Lee (Victor_Lee@ClinicalArchitecture.com) to inquire or to request development

Clinical Architecture and other Alliance collaborators are donating our efforts, and Clinical Architecture is leveraging its software tooling, hosting infrastructure, and manual labor to donate all of the COVID-19-related value set content to the public domain (i.e., completely free, no strings attached). That being said, we all have day jobs, so we appreciate having as much lead time as possible to fulfill requests. Happy to take questions.

• Registries, e.g., from specialty societies. (discuss with Frank Opelka, ACS)

• [under development] MCBK Standards WG Metadata work
• standards that do (or could) underpin registries

• MedMorph, DEQM FHIR IG

• eCQI Resource Center
• UMich/MCBK Knowledge Grid efforts
• MCBK UK ‘knowledge hackathons’ to implement NICE guidelines
• AHRQ-funded toolkit for ePROs in patient care
• NQF project to create a measurement framework linking quality of care delivered by telehealth, healthcare system readiness, and health outcomes in a disaster