IHE Patient Care Coordination profiles for 2015
November 17, 2014 in Medical Technology
Several IHE Domains met last week to discuss work items for the coming season of interoperability. IHE IT Infrastructure’s 2015 Plan is described by John Moehrke on his blog. IHE PCC started with eight work items, which we reduced to six and moved forward with.
RECON on FHIR takes the IHE Reconciliation work and adapts it for use with FHIR. The basic challenge addressed by this profile is how to represent the reconciliation act. Fortunately, FHIR has the List resource, and that actually covers everything we probably need for this profile, and was designed in part for this kind of use.
Clinical Decision Support for Radiology is one we’ll be developing on behalf of IHE Radiology, but will likely remain a PCC profile. The idea behind this one is that ordering physicians and radiologists here in the US will soon be required to verify that certain kinds of imaging orders are appropriate in order to get paid. Other countries, while not so draconic in policies, are starting to have an interest in this sort of order review as well. So, we want to have some sort of CDS verify the order as it is created, and as it is received, and to gather additional information if necessary. For this, we’ll likely use something like RFD if additional information needs to be gathered, but otherwise, simply return a token of some sort from the CDS system indicating that the order is deemed appropriate according to some guideline. Then the receiver can simply verify the token if so desired, or test the order against its own set of appropriateness guidelines.
Device Observation Semantic Bridge will probably get renamed. The point of this one is that some EHR systems would like to have a simplified summary of device observations created to make it easier for them to store the information, in CDA rather than HL7 V2 format. So, we’ll have a content profile that explains how to convert V2 device observations to CDA, create a summary and link it to the device observation. We’ll also have another integration profile that explains how to get vocabulary mappings from one system to another. We will likely be using CTS 2 to support that, although there may be some interaction also with FHIR. One supplement, two profiles.
Remote Patient Monitoring takes what Continua and IHE have been doing and demonstrating for the last half decade and make it into a profile. This one should really be very simple. The main point is to have a profile that enables Continua specifications to be tested at connectathon. This one may go back to PCD once we have finished it, and we expect this one to come out early because it is so well understood.
Remote Read is a Workflow profile that will likely be owned by IHE Radiology when it is complete, but which will be supported by PCC during development. I also expect to work on an appendix for IHE PCC which shows how to define a Workflow Profile using BPMN 2.0.
Data Access Framework will be an interesting animal. One part of it will be a framework for supporting document queries in health information exchange, which will become a PCC Profile. Another part of it will be developing US National extensions, mostly on IHE ITI profiles for how they are to be used (which options and vocabulary are required, for example), and a last part of it will be an implementation guide which pulls it all together, that to be developed in IHE USA.
One profile didn’t make it through because the author wasn’t there to defend it at all. Other work includes cleaning up some long-standing problems with a missing transaction for “Share Content” in Content profiles, and doing further outreach in Nursing.