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An Architecture for CDS and Quality Measurement

An Architecture for CDS and Quality Measurement

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An Architecture for CDS and Quality Measurement

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  1. 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 Dictionary

  3. Building Architectural Components

  4. HL7 (SAIF) Architectural Components

  5. SAIF in Simple Terms

  6. SAIF in Simple Terms Common Meta data QI Policy

  7. *Transparent = Invisible

  8. 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. What is Metadata Used to Find & Manage Things [Governance] • Subject • Provenance • Security & Privacy • Descriptive • Exchange • Object Lifecycle • Relationships -- See Healthcare Metadata

  10. 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. Reverse Engineering a Product Architecture • Specification Teardown • Overlaps and Gaps • Similarities and Differences • Identify Opportunities • Agree to disagree, or to work it out • Plan the Journey Ahead

  12. 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. 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. Opportunities and Variations • What’s the low hanging fruit? • Successes? Failures? • What Variations are OK? Not? • How long will it take to fix?

  15. 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. Questions? ?