HSPC Relationship to Other Initiatives February 5, 2015 Stanley M. Huff, MD Chief Medical Informatics officer Intermountain Healthcare

Principles We want to work together to build a single shared solution I am not very excited about “harmonization” Matching models or capabilities between two things that will both go forward Don’t put so much effort and collaboration, sharing, and harmonization that we don’t create HSPC value

Some Related Initiatives HL7, and HL7 FHIR SMART on FHIR Argonauts Center for Medical Interoperability (C4MI) CIMI and openEHR SOLOR and ISAAC ONC Initiatives Commonwell Alliance HealtheWay Others?

HL7 and HL7 FHIR We have decided to use HL7 FHIR We are working with Grahame Grieve and other HL7 FHIR leadership to insure our work is consistent with “standard” FHIR We are producing HL7 FHIR profiles Work with all groups to create a single set of approved FHIR profiles We want our FHIR profiles to be part of the official FHIR artifacts (FHIR.org?) We are promoting HL7 as the place to convene a group to review and approve a single set of FHIR profiles for interoparability

SMART on FHIR We are implementing SMART on FHIR as HSPC’s initial data virtualization strategy Our goals and aspirations are aligned with SMART We want SMART related issues to be discussed and managed by SMART OAuth2 Context sharing Integration of apps into EHRs Etc. We want to support SMART and avoid overlapping efforts

Argonauts Primarily raising funds to pay to accelerate existing efforts Accelerate the production of FHIR profiles Data Access Framework FHIR Profiles Focused on MU “Common Data Elements” Accelerate work with Dixie Baker and Josh Mandel to further configure and enhance security (OAuth2) Project management HSPC is excited that money is being provided to accelerate standards activities

Center for Medical Interoperability Gary and Mary West Foundation Members – Johns Hopkins, Ascension, Intermountain, HCA, Vanderbilt, Geisinger, … Goals are aligned with HSPC Stan Huff made a presentation to C4MI in January Seeing if aspects of HSPC might be supported by C4MI

Proposal: … Possible types of realization support Certifier of apps and services Builder and keeper of reference implementations Provide the vendor independent “healthcare app store” Public relations and promotion of HSPC as a solution Creation and distribution of “How to” articles and implementation guides

Clinical Information Modeling Initiative and openEHR We plan to use CIMI models as a source of information for creating HSPC approved FHIR Profiles CIMI is applying to become a part of IHTSDO openEHR member(s) are very active part of CIMI Potential conflict and overlap

Current Process HSPC approved HL7 FHIR Profiles Standard FHIR Terminologies FHIR Resources HSPC approved HL7 FHIR Profiles Translator (or manual) Intermountain CEMs

Future Process HSPC approved HL7 FHIR Profiles Standard HL7 FHIR Terminologies HL7 FHIR Resources HSPC approved HL7 FHIR Profiles Translator (or manual) CIMI Models Intermountain CEMs openEHR Archetypes

Even more Future Process Standard Terminologies HL7 FHIR Resources HSPC approved HL7 FHIR Profiles Translator (or manual) CIMI Models

HL7 FHIR Resources and Profiles Observation Lab Obs Patient Obs Family Hx Obs FHIR Profiles Qn Lab Obs Titer Lab Obs Qual Lab Obs Hematocrit Serum Glucose Urine Sodium Invariant Profile Structure – CIMI Leaf Node Content

SOLOR and ISAAC Keith Campbell, Steve Brown, Michael Lincoln Description logic based model representation Consistent, non-overlapping subset of SNOMED CT, LOINC, and RxNorm

Possible Isaac/SOLOR Strategy 1 HL7 FHIR Resources HSPC approved HL7 FHIR Profiles Translator (or manual) CIMI Models Isaac (LEGOS) SOLOR

Possible Isaac/SOLOR Strategy 2 HL7 FHIR Resources HSPC approved HL7 FHIR Profiles SOLOR Translator (or manual) Isaac (LEGOS)

ONC S&I Framework Initiatives Clinical Quality Framework (Tacoma) Data Access Framework Structured Data Capture (Clinical Decision Support Services) We want to keep ONC informed about HSPC activities We want to have our FHIR profiles common with ONC

Commonwell Alliance To date, has been mostly focused on “clinistrative” transactions Potential overlap to the extent that Commonwell’s approach overlaps with HL7 FHIR based services

HealtheWay “Mostly” creating network connections and data use agreements – that is good Potential conflict as HealtheWay moves into interoperable clinical data exchange Opportunity to work together

Others…

Questions and Discussion