VA seeks robust CDS for iEHR

July 5, 2012 in Medical Technology

WASHINGTON – The Veterans Affairs Department wants industry help to describe standard technical specifications for services that are needed for clinical decision support that could be incorporated in its integrated electronic health record (iEHR) with the Defense Department.

Clinical decision support (CDS) is currently linked with specific vendor electronic health record software and modules. The Interior Department’s National Business Center, which is working on behalf of the VA, wants to develop CDS functionality as a service.

[See also: VA CIO: 'When we get it done, it will be open source'.]

The goal is to define the service interface specifications for electronic health records that would enable a service-oriented architecture (SOA) approach to CDS for the VA and DOD iEHR and also to serve as a basis of international health IT standards, according to a June 28 announcement in Federal Business Opportunities.

Comments are due July 9. The National Business Center anticipates awarding a year-long contract in September.

The iEHR service-oriented architecture, which will be coordinated by an enterprise service bus, will allow for the efficient addition of advanced capabilities, including clinical decision support.

Advanced clinical decision support capabilities are not widely available. “While there are many reasons for this limited availability, an important reason is that CDS capabilities are typically tightly coupled to individual software modules within specific clinical information systems,” according to the notice.

[See also: VA, DoD poised to launch open source dictionary.]

For example, an alerting capability may be tightly coupled to the computerized provider order entry (CPOE) module of a specific EHR system.

As the scope of potentially useful clinical decision support elements surpass the scope of CDS that can be reasonably provided by any single vendor, it becomes critical to establish an architectural framework in which CDS capabilities can be developed by multiple independent groups and used in multiple systems, according to the notice.

The Health Level Seven (HL7) CDS Work Group identified through a community consensus process 10 clinical information system services and eight capabilities as important for enabling scalable, service-oriented CDS. 

[See also: QA: 3M spurs interoperabilty, innovation with DoD and VA iEHR.]

The National Business Center plans to focus on developing service interface specifications for event subscription and notification service; order placement service; and user communication service. From the group discussions, these were considered priority services but have no standard service specifications, the notice said.

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