cds-hooks
Terminology for EHR triggers
Is there a plan to define a controlled terminology for EHR triggers of CDS Hooks? Options like “medication-prescribe” and “order-review” are strikingly similar to the HL7 ActTaskCode value set (https://www.hl7.org/fhir/v3/ActTaskCode/vs.html) within the HL7 ActCode code system. For example, "order-review" is "OREV" and "medication-prescribe" is "MEDOE". Why not just adapt the ActTaskCode value set for CDS Hooks?
In this 2009 paper, Clinical decision support capabilities of commercially-available clinical information systems, a list of common EHR triggers are listed. It seems to be good starting point.
Per discussion at the Sept WGM (Tue Q2), we should encourage people creating hook definitions that the HL7 ActTaskCode value set exists. However, this value set may be more broad than what we are defining today with our hook definitions.
@gdelfiol brought up an excellent point that this value set was defined for Infobutton and allows new values to be defined outside of the Infobutton spec. CDS Hooks would benefit from externalizing the hook definitions outside of the spec so that new hook definitions don't require new CDS Hooks spec releases.
HL7 has agreed to define a set of trigger codes. Some - or many - of these will be candidates for cds-hook definitions
@grahamegrieve, where is the work to define this set of triggers being done?
It’s done through HL7 harmonization, which happens before each HL7 WG. Requests are submitted offline and discussed in a conference call.
http://www.hl7.org/events/harmonization/index.cfm?ref=nav http://wiki.hl7.org/index.php?title=Vocabulary_and_RIM_Harmonization_Process
@gdelfiol, do you know whether the ActTaskCode value set was developed specifically for InfoButton, or was it already present and InfoButton used it?
It was initially developed for Infobutton (I presented the proposal at vocab harmonization), but then other groups proposed additions over time.
From: Bryn Rhodes [email protected] Reply-To: cds-hooks/docs [email protected] Date: Monday, December 11, 2017 at 2:44 PM To: cds-hooks/docs [email protected] Cc: Guilherme Del Fiol [email protected], Mention [email protected] Subject: Re: [cds-hooks/docs] Terminology for EHR triggers (#52)
@gdelfiolhttps://github.com/gdelfiol, do you know whether the ActTaskCode value set was developed specifically for InfoButton, or was it already present and InfoButton used it?
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@gdelfiol, that's great! Do you have a sense for how well supported the codes are within EHR implementations? Do the InfoButton integrations actually implement workflow points at these codes?
I am familiar with the implementation in one EHR and it’s fairly good. It does not support all the codes on ActTaskCode, but the ones they use are correct. Knowledge vendors implemented them fairly well too. The most common ones that are supported are probably problem list review, problem list entry, laboratory results review, medication list review, and medication order entry.
From: Bryn Rhodes [email protected] Reply-To: cds-hooks/docs [email protected] Date: Monday, December 11, 2017 at 3:47 PM To: cds-hooks/docs [email protected] Cc: Guilherme Del Fiol [email protected], Mention [email protected] Subject: Re: [cds-hooks/docs] Terminology for EHR triggers (#52)
@gdelfiolhttps://github.com/gdelfiol, that's great! Do you have a sense for how well supported the codes are within EHR implementations? Do the InfoButton integrations actually implement workflow points at these codes?
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