FEBRUARY 5 , 2015

STANLEY M. HUFF, MDCHIEF MEDICAL INFORMATICS OFFICER

INTERMOUNTAIN HEALTHCARE

HSPC Relationship to Other Initiatives

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 forwardDon’t put so much effort and collaboration,

sharing, and harmonization that we don’t create HSPC value

Some Related Initiatives

HL7, and HL7 FHIRSMART on FHIRArgonautsCenter for Medical Interoperability (C4MI)CIMI and openEHRSOLOR and ISAACONC InitiativesCommonwell AllianceHealtheWayOthers?

HL7 and HL7 FHIR

We have decided to use HL7 FHIRWe 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 managementHSPC is excited that money is being provided

to accelerate standards activities

Center for Medical Interoperability

Gary and Mary West FoundationMembers – Johns Hopkins, Ascension,

Intermountain, HCA, Vanderbilt, Geisinger, …Goals are aligned with HSPCStan Huff made a presentation to C4MI in

JanuarySeeing if aspects of HSPC might be

supported by C4MI

© Center for Medical Interoperability, Inc.

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 IHTSDOopenEHR member(s) are very active part of

CIMI Potential conflict and overlap

Current Process # 10

IntermountainCEMs

StandardTerminologies

HSPC approvedHL7 FHIR

Profiles

Translator(or manual)

FHIRResources

Future Process # 11

CIMIModels

StandardTerminologies

HSPC approvedHL7 FHIR

Profiles

Translator(or manual)

HL7 FHIRResources

IntermountainCEMs

openEHRArchetypes

Even more Future Process # 12

CIMIModels

StandardTerminologies

HSPC approvedHL7 FHIR

Profiles

Translator(or manual)

HL7 FHIRResources

# 13

HL7 FHIR Resources and Profiles

Observation

Lab Obs Patient Obs Family Hx Obs

Qn Lab Obs Titer Lab ObsQual Lab Obs

Hematocrit Serum Glucose Urine Sodium

FHIR Resource

FHIR Profiles

Invariant Profile Structure – CIMI Leaf Node Content

SOLOR and ISAAC

Keith Campbell, Steve Brown, Michael Lincoln

Description logic based model representationConsistent, non-overlapping subset of

SNOMED CT, LOINC, and RxNorm

Possible Isaac/SOLOR Strategy 1

# 15

CIMIModels

SOLOR

HSPC approvedHL7 FHIR

Profiles

Translator(or manual)

HL7 FHIRResources

Isaac (LEGOS)

Possible Isaac/SOLOR Strategy 2

# 16

SOLOR HSPC approvedHL7 FHIR

Profiles

Translator(or manual)

HL7 FHIRResources

Isaac(LEGOS)

ONC S&I Framework Initiatives

Clinical Quality Framework (Tacoma)Data Access FrameworkStructured 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