HL7 FHIR Connectathon 2024 January
Evidence-Based Medicine Track
© 2019+ Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
2024-01-18
What was the track trying to achieve?
Goal 1 – introduce EBMonFHIR IG
Goal 2 – Demonstrate Population/Intervention searches for FHIR Compositions (using FHIR ArtifactAssessment - Classification Profile)
Bonus point – coordination with terminologies for alias mapping
Goal 3 – Solve complex examples of RelativeTime datatype (e.g. with Group.characteristic.timing use)
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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List of participants-16 total participants
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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Notable achievements
All goals successfully achieved !
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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Goal 1 – Introduce EBMonFHIR IG
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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Goal 1 – Introduce EBMonFHIR IG
Summary: We introduced the Evidence Based Medicine Implementation Guide to representatives from multiple organizations.
We demonstrated using the FEvIR Platform to create a computable guideline using FHIR Resources and discussed the ability to create an organization specific profile of the Guideline Profile for a professional society such as the American College of Cardiology. We demonstrated how we could convert Medline citations or RIS based citations to FHIR Citation Resources.
We also introduced a representative from the HL7 DaVinci Accelerator to creating a cohort definition in FHIR (specifically the CohortDefinition Profile of Group Resource) and discussed examples for prior authorization and for risk adjustment (e.g., by defining a group of hospitals within a specific geographic area).
We demonstrated the display and editing of a ComparativeEvidenceReport Profile of Composition Resource with the Computable Publishing®: Comparative Evidence Report Viewing Tool (showing https://fevir.net/resources/Composition/178426) and Computable Publishing®: Comparative Evidence Report Authoring Tool, and also reviewed a ComparativeEvidence Profile of Evidence Resource (showing https://fevir.net/resources/Evidence/104155).
We demonstrated the automated conversion of a ClinicalTrials.gov study record (NCT05704088) to FHIR Resources (starting with https://fevir.net/resources/ResearchStudy/193262) and how this uses the Group Resource for the study eligibility criteria.
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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Goal 2 – Demonstrate Population/Intervention searches for FHIR Compositions (using FHIR ArtifactAssessment - Classification Profile)� Bonus point – coordination with terminologies for alias mapping
Summary: We tested the API from the FEvIR Platform which uses the Classification Profile of the ArtifactAssessment Resource in its search index. We established that Duodecim was able to use the API to specify a search and retrieve the desired FHIR Composition Resources. We were also able to demonstrate the “bonus point” where Duodecim specified their search request using their alias codes and received the search response based on SNOMED-CT and ICD-10 codes for a population and intervention (PICO) search.
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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The link in the CDS reminder triggers a search from the FEvIR platform, using the aliases to match codes from the EHR and from the evidence resources
The search results include (links to) the evidence resources (summary of findings and summary of net effects)
Guideline development tools have APIs that allow exporting data in structured format. The data can be converted into FHIR format (FEvIR)
Computable data converted from MAGICApp is displayed in a viewing tool.
The evidence is classified (indexed) with codes (e.g. SNOMED CT) either by original guideline developer or third parties. Further enrichment of the data is made possible by authoring tools
Example of a derivative product: summary of net effect
Goal 3 – Solve complex examples of RelativeTime datatype (e.g. with Group.characteristic.timing use)
To represent a timing of “From the beginning of the day before surgery until the end of the surgery” we suggested 2 RelativeTime datatype instances with a pattern like:
{ conceptCode: ‘beginning of the day of surgery’ or ’00:00 am on day of surgery’,
offsetDuration: > -1 day or > -24 hours },
{ conceptCode: ‘end of surgery’,
offsetDuration: < 0 }
To represent a characteristic of an intervention that it should be executed in at least 2 of 3 daily shifts, we considered either of:
Group.characteristic
.code = “number of shifts/day with intervention executed”
.valueQuantity = >= 2
or
Group.combinationMethod = “at-least” and Group.combinationThreshold = 2 and 3 characteristics with each characteristic specifying 1 of the 3 daily shifts
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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Discovered issues
·
We created a new error message for search where no items are found (discovered in the MEDLINE-to-FEvIR Converter)
We Created a JIRA ticket https://jira.hl7.org/browse/FHIR-43696 to Add RelativeTime to timing[x] in PlanDefinition and ActivityDefinition
What Next? - HEvKA Weekly Virtual Meeting Schedule
© 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4.0 International HL7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
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