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

2. 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

3. 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?

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

11. 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

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

13. 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

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

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

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

17. 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

18. 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

19. 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

20. Others…

23. Questions and Discussion