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

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

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

1September 2013

An Architecture for CDS and Quality Measurement

September 2013

Page 2: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

2September 2013

Architecture

The manner in which the components of a computer or computer system are organized and integrated

-- Merriam-Webster Online Dictionary

Page 3: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

3September 2013

Building Architectural Components

Page 4: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

4September 2013

HL7 (SAIF) Architectural Components

Page 5: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

5September 2013

SAIF in Simple Terms

Viewpoints Business Requirements

Information Models

Behavioral Models Engineering & 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 Models Collaboration Patterns, Interface / Service Specifications (e.g., WSDL)

Existing Models, Libraries, Intended Transparencies*

Platform Specific

Rules, Procedures Physical Models, Schemas

Scripts, Orchestrations, Interface Implementations

APIs, Protocols, Transforms, ITS, Deployment Models

Page 6: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

6September 2013

SAIF in Simple Terms

Viewpoints Business Requirements

Information Models

Behavioral Models Engineering & Technology

Specifications

Conceptual QI Whitepaper QI DAM QI Functional Requirements

Product List

Platform Independent

QI D-MIM QI Logic Expression Transparency Principles

Platform Specific

QRDA, HQMF, HeD Knowledge Artifact, VMR, CCDA R2?

HeD Knowledge Artifact, HQMF

Common Metadata

QI Policy

Page 7: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

7September 2013

*Transparent = Invisible

Transparency What it Makes Invisibleaccess differences in data representation and

procedure calling mechanism

location physical addresses, including the distinction between local versus remote

migration & relocation

relocation of an object

persistence deactivation and reactivation of an objectfailure failure and possible recovery of objectsreplication maintenance of consistency between replicastransaction coordination of transactions

Page 8: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

8September 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

Page 9: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

9September 2013

What is Metadata

Used to Find & Manage Things [Governance]SubjectProvenanceSecurity & PrivacyDescriptiveExchangeObject LifecycleRelationships

-- See Healthcare Metadata

Page 10: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

10September 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

Page 11: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

11September 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

Page 12: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

12September 2013

Specification Teardown

Using your PSS and SpecificationWrite down the Spec Name on several Post-it Notes Identify SAIF Components in your Spec/PSSPut it up on the chartRepeat until DoneDon’t Sweat the Small Stuff

Page 13: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

13September 2013

Overlaps & Gaps, Similarities and Differences

Identify OverlapsIf two components are similar, put them

closer together.If different, farther apart.Is anything missing? Are you sure?Look for hidden assumptions

Page 14: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

14September 2013

Opportunities and Variations

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

Page 15: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

15September 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?

Page 16: 1 September 2013 An Architecture for CDS and Quality Measurement September 2013

16September 2013

Questions?

?