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Brian S. Alper, MD, MSPH, FAAFP, FAMIA, FGIN

CEO, Computable Publishing LLC; President, Scientific Knowledge Accelerator Foundation;

Project Lead, EBMonFHIR; Project Lead, Health Evidence Knowledge Accelerator

X: @BrianAlperMD balper@computablepublishing.com

HL7®, and FHIR® are the registered trademarks of Health Level Seven International and their use of these trademarks does not constitute an endorsement by HL7.

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Introduction to EBMonFHIR

Introduction to open-source standards and tools for Real World Evidence

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Disclosure

  • I disclose the following relevant relationship with commercial interests:
    • Owner of Computable Publishing LLC
    • Computable Publishing LLC owns the Fast Evidence Interoperability Resources (FEvIR) Platform

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  • I disclose the following relevant relationships with non-commercial interests:
    • President of Scientific Knowledge Accelerator Foundation
    • Project Lead for Health Evidence Knowledge Accelerator
    • Project Lead for EBMonFHIR (an HL7® project to extend HL7® FHIR® to support computable evidence and guidance)

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HL7® and FHIR® are the registered trademarks of Health Level Seven International and their use of these trademarks does not constitute an endorsement by HL7.

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Learning Objectives

After participating in this session, the learner should be better able to:

    • Understand how the FHIR standard for health data exchange is being extended to data exchange for scientific evidence and guidance.

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Produce guidance

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Disseminate guidance

Implement guidance and decision support

Synthesize evidence

Produce evidence

Evaluate and improve practice

Image adapted from MAGIC Evidence Ecosystem Foundation

Image Adapted from MAGIC Evidence Ecosystem Foundation

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HL7® FHIR® MAKES HEALTH DATA FAIR

  • Fast Healthcare Interoperability Resources (FHIR)® is an HL7® standard for electronic data exchange
  • HL7 FHIR solves long-intractable problems of sharing health data
  • Resources (the R in FHIR) is the technical HOW – small digital object as shareable value unit
  • HL7 standards development process is the human HOW
  • HL7 FHIR enables data to be Findable, Accessible, Interoperable and Reusable (FAIR)

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Produce guidance

Guidelines, Decision Aids, Clinical Decision Support

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Disseminate guidance

Implement guidance and decision support

Synthesize evidence

Systematic Reviews

Produce evidence

Research Studies

Evaluate and improve practice

NOT health data exchange

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Healthcare Knowledge Ecosystem Today

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Data

Evidence

Guidance

Action

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Healthcare Knowledge Ecosystem Desired

Data Analysis, Synthesis, and Interpretation.

EVIDENCE

Guidelines, Recommendations, Decision Aids, Decision Support

GUIDANCE

Observations and Measurements.

DATA

Healthcare (testing and intervention) decision-making and implementation

ACTION

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EBMonFHIR extends HL7 FHIR to EBM data

  • FHIR Resources for Evidence-Based Medicine (EBM) Knowledge Assets project (EBMonFHIR) was approved on May 16, 2018 as an HL7 project.
  • EBMonFHIR sponsored by 3 HL7 Work Groups
    • Clinical Decision Support (CDS)
    • Clinical Quality Information (CQI)
    • Biomedical Research and Regulation (BRR)
  • Goal: provide interoperability for clinical research (evidence) and recommendations for clinical care

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Health Evidence Knowledge �Accelerator (HEvKA)

  • A virtual organization – no cost, no contracts
  • Open, transparent – all meetings
  • A way for any to volunteer to accelerate development and implementation of standards for evidence exchange, especially with attention to health evidence and evidence-based guidance

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FEvIR.net/HEvKA

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Day/Time (Eastern US)

Working Group

Agenda Items

Monday 8-9 am

Project Management

FHIR changes and EBMonFHIR Implementation Guide issues

Monday 1-2 pm

Research Study Data Dictionary (a CDS EBMonFHIR sub-WG)

Review EvidenceVariable StructureDefinition, create example

Tuesday 9-10 am

Measuring the Rate of Scientific Knowledge Transfer (SKAF Board meeting monthly)

Prepare study protocol for submission

Tuesday 2-3 pm

StatisticsOnFHIR (a CDS EBMonFHIR sub-WG)

Review PARACHUTE RCT example

Wednesday 8-9 am

Making Guidelines Computable

Prioritize features for a guideline development tool

Wednesday 9-10 am

Communications (Awareness, Scholarly Publications)

3 publications (SEVCO 2.0, MGC, Measuring the Rate), presentations (GIN, MCBK, Peer Review Congress)

Thursday 8-9 am

EBM Implementation Guide (a CDS EBMonFHIR sub-WG) (GINTech every 6 weeks)

Review Composition Profiles

Thursday 9-10 am

Computable EBM Tools Development

Tooling for DichotomousPatientImportantOutcome Profile

Friday 9-10 am

Statistic Terminology

Prepare for SEVCO 2.0 dissemination (scholarly publication)

Friday 10-11 am

GRADE Ontology

Problem Importance, Desirable Effects, Undesirable Effects, Certainty of Evidence across All Outcomes, Values and Preferences

Friday 12-1 pm

Project Management

Plan weekly agenda

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Thank you!

Email me at: balper@computablepublishing.com