1 September 2013 An Architecture for CDS and Quality Measurement September 2013

2 Architecture The manner in which the components of a computer or computer system are organized and integrated -- Merriam-Webster Online DictionaryMerriam-Webster Online Dictionary

3 September 2013 Building Architectural Components

4 September 2013 HL7 (SAIF) Architectural Components

5 September 2013 SAIF in Simple Terms Viewpoints Business Requirements Information Models Behavioral ModelsEngineering & Technology Specifications Conceptual Scope, Problem Statement, Story Boards, Use Cases Domain Analysis Model, Clinical Statement Pattern Functional Specs, Service Roles & Relationships, Application Roles & Interactions Compatibility, Existing Platforms, Design Patterns Platform Independent Authorities and Alignments, Core Principles, Priorities, Methodology Logical ModelsCollaboration Patterns, Interface / Service Specifications (e.g., WSDL) Existing Models, Libraries, Intended Transparencies* Platform Specific Rules, ProceduresPhysical Models, Schemas Scripts, Orchestrations, Interface Implementations APIs, Protocols, Transforms, ITS, Deployment Models

6 September 2013 SAIF in Simple Terms Viewpoints Business Requirements Information Models Behavioral ModelsEngineering & Technology Specifications Conceptual QI WhitepaperQI DAMQI Functional Requirements Product List Platform Independent QI D-MIMQI Logic ExpressionTransparency Principles Platform Specific QRDA, HQMF, HeD Knowledge Artifact, VMR, CCDA R2? HeD Knowledge Artifact, HQMF Com mon Meta data QI Policy

7 September 2013 *Transparent = Invisible TransparencyWhat it Makes Invisible access differences in data representation and procedure calling mechanism location physical addresses, including the distinction between local versus remote migration & relocation relocation of an object persistencedeactivation and reactivation of an object failurefailure and possible recovery of objects replicationmaintenance of consistency between replicas transactioncoordination of transactions

8 September 2013 What is a Template A set of constraints on a model. Further refines existing models to narrow scope. Represented by a formal definition. Used to validate instances. Summarized from HL7 Templates DSTU and Ballot Draft

9 September 2013 What is Metadata Used to Find & Manage Things [Governance] Subject Provenance Security & Privacy Descriptive Exchange Object Lifecycle Relationships -- See Healthcare MetadataHealthcare Metadata

10 September 2013 HL7 Specifications Related to Quality Improvement VMR for CDS Logical Model VMR for CDS Templates VMR for CDS XML Implementation Guide HED Knowledge Artifact Implementation Guide Decision Support Service Implementation Guide HQMF Specification HQMF QDM-Based Implementation Guide CCDA Specification QRDA Specification Arden Syntax GELLO InfoButton QDM XML ITS (1 & 2) Data Types RIM Clinical Statement Pattern

11 September 2013 Reverse Engineering a Product Architecture 1.Specification Teardown 2.Overlaps and Gaps 3.Similarities and Differences 4.Identify Opportunities 5.Agree to disagree, or to work it out 6.Plan the Journey Ahead

12 September 2013 Specification Teardown Using your PSS and Specification Write down the Spec Name on several Post-it Notes Identify SAIF Components in your Spec/PSS Put it up on the chart Repeat until Done Don’t Sweat the Small Stuff

13 September 2013 Overlaps & Gaps, Similarities and Differences Identify Overlaps If two components are similar, put them closer together. If different, farther apart. Is anything missing? Are you sure? Look for hidden assumptions

14 September 2013 Opportunities and Variations What’s the low hanging fruit? Successes? Failures? What Variations are OK? Not? How long will it take to fix?

15 September 2013 Plan and Prioritize What can be delivered by November for Ballot, or January for Publication What needs more time? Where will the puck be … In 6 months? In 12 months? How do we get there? What is the path of least regret?

16 September 2013 Questions? ?