Inside HL7 Clinical Decision Support Karsten Fehre, Klaus-Peter Adlassnig Medexter Healthcare Borschkegasse 7/5 A-1090 Wien www..com & Institut für Medizinische Experten- und Wissensbasierte Systeme Zentrum für Medizinische Statistik, Informatik und Intelligente Systeme Medizinische Universität Wien Spitalgasse 23 A-1090 Wien www.meduniwien.ac.at/kpa Jahrestagung HL7 Austria, Wien, 18. März 2015
Clinical decision support for patient safety and quality assurance patients structured medical data (HIS, LIS, PDMS, Web, documentation, ) diagnostic support therapy advice alerts, reminders, to-do lists clinical interpretation, (tele)monitoring differential diagnostics rare diseases, rare syndromes further or redundant examinations diagnostic completeness (multi-morbidity) consensus-criteria-based evaluations disease classification and surveillance criteria illness severity scores, prediction rules trend detection and visualization hospital management and quality benchmarking evidence-based reminders and processes computerized clinical guidelines, protocols, standard operating procedures healthcare-associated infection surveillance T prognostic prediction drug alerts, reminders, calculations indication, contraindications, redundant medications, substitutions dosage calculations, drug-drug interactions, adverse drug events management of antimicrobial therapies, susceptibility and resistance rates open- and closed-loop control systems structured medical knowledge (rules, tables, trees, guidelines, )
Clinical decision support related groups within HL7 Arden Syntax WG Clinical Decision Support WG HQMF (Structured Documents / CDS)
HL7 activities toward standards Arden Syntax for Medical Logic Systems, Version 2.10 (May, 2014) HL7 Version 3 Standard: Gello; A Common Expression Language, Release 2 (April 2010) HL7 Version 3 Standard: Virtual Medical Record for Clinical Decision Support (vmrcds) Logical Model, Release 2 (January 2014) HL7 Version 3 Standard: Clinical Decision Support Knowledge Artifact Specification, Release 1.1 (April 2014) HL7 Decision Support Service (2011) Infobutton,
What is Arden Syntax? a language used for representing and sharing medical knowledge. used for sharing of computerized health knowledge bases across personnel, information systems, and institutions. organized using modules, while each module, referred to as a medical logic module (MLM), contains sufficient knowledge to make a single decision. an executable format which can be used by systems.
History Version Year Important changes 2.1 2002 2.5 2005 2.6 2007 2.7 2008 2.8 2012 new string operators; reserved word currenttime returns the system time object capabilities: create and edit objects; XML representation of MLMs (except logic, action and data slot) UNICODE encoding; additional resources category to define text resources for specific languages; time-of-day and day-of-week data types; localized operator to access texts in specific languages enhanced assignment statement; extended new operator to allow easy and flexible object instantiation additional operators for list manipulation; operators to manipulate parts of given date and time values; switch statements; keyword breakloop for aborting a loop; number of editorial corrections 2.9 2013 2.10 2014 fuzzification: fuzzy data types and fuzzy sets; adjustment of all available operators to be able to handle fuzzy data types XML representation of whole MLMs (including logic, action and data slot)
Future Plans for Arden Syntax Arden Syntax v3 Common data model or implicit data model link through curly braces Implementation Guide R2 Arden Syntax test and/or certificate
CDS WG Activities Meaningful Use Stage 2 + 3 Health edecision (ONC) CQL, QDM, HQMF, QIDAM, vmr, FHIR, (QUICK) Infobutton Clinical Decision Support Services Big Picture CQL=Clinical Quality Language, QDM=Quality Data Model, HQMF=Health Quality Measure Format, QIDAM=Quality Improvement Domain Analysis Model
CDS WG Activities cont.