Two Significant S&I Framework Milestones: the Health eDecision Initiative Close-Out and Clinical Quality Framework Launch

As you know, measuring quality and improving quality are key parts of improving health, health care and increasing efficiency. Within the S&I Framework, the Health eDecisions (HeD) project has led the charge in accelerating standards to support clinical decision support.


The Health eDecision (HeD) initiative will be coming to a close on March 27 (after a successful 21-month run!), but this is only the beginning of our quality efforts, not the end. On March 21, 2014 in collaboration with CMS, we will be launching a new initiative called Clinical Quality Framework (CQF). External Links Disclaimer

The new collaborative initiative will build on the work of the HeD project by focusing on harmonizing the standards for clinical decision support AND electronic clinical quality measurement.

While many of you in the standards community already know the incredible work of the HeD initiative, I’d like to highlight the significant achievements of HeD.

The Health eDecision Initiative was launched in June 2012.  Led by Ken Kawamoto, Tonya Hongsermeier, Aziz Boxwala, Bryn Rhodes and Jamie Parker, this passionate, dedicated (and well organized) community was able to achieve significant progress in standards harmonization for Clinical Decision Support.  In less than 2 years the HeD community completed work on 2 Use Cases:

  • Clinical Decision Support Artifact Sharing – this use case answered the question “How can I share a really good clinical decision support rule with someone else in an electronic format, so they can use the rule in their electronic health record?”
  • Clinical Decisions Support Guidance Service – this use case answered the technical question of “How can I send important data to an up-to-date website or service that will give me advice about immunizations or other complex decisions?”

It sounds easy, but for readers unfamiliar with how standards are developed (and how challenging it can be to get national consensus on standards) this work was no small feat.  The HeD community evaluated and harmonized Clinical Decision Support Standards, created three implementation guides and authored six HL7 standards with the guidance of the HL7 Clinical Decision Support Work Group.  All of these standards and implementation guides are ready to be used and tested as “draft standards” within HL7. These standards include:

  1. Clinical Decision Support Knowledge Artifact Implementation Guide
  2. Decision Support Service Implementation Guide
  3. Virtual Medical Record (vMR) Logical Model
  4. vMR XML Specification
  5. vMR Templates
  6. Decision Support Service (DSS) Standard

Those familiar with the 2015 Edition NPRM will notice the first two items have been included in the proposed notice published in the Federal Register.  Additionally, the HeD team was able to coordinate pilots of both HeD use cases with vendors and content providers and then hold the first ever S&I Pilots Virtual Open House.

In appreciation of all the hard work that the community has done, we will be honoring those who participated in the initiative at another “first ever:” the S&I Initiative Virtual Closing Ceremony on March 27th from 11:00 am-12:30 pm ET.   The virtual closing ceremony will include a review of the initiative’s accomplishments, insights from the HeD initiative participants and sharing of “real world” applications of their work.  Anyone interested in this work is invited to attend to help celebrate this accomplishment for both HeD and the S&I Framework.  Call-in information and web details are available at http://wiki.siframework.org/Health+eDecisions+Homepage External Links Disclaimer

I’d like to offer my sincere thanks and congratulations to the HeD community for their hard work and commitment to ONC’s continued march toward interoperability.  I’m looking forward to seeing this work being furthered by the upcoming CQF Initiative.

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