A significant barrier to the efficient exchange of health information is the management of patient consent directives. This barrier not only influences point-of-care services that require data exchange but also has far-reaching implications for the secondary use of electronic health record data for public health, disease registries, and research.
To tackle this challenge, individuals from healthcare information exchange operator San Diego Health Connect and Cognitive Medical Systems, Inc., are creating a Health Level Seven International® (HL7®) Fast Healthcare Interoperability Resources® (FHIR®)–based platform that will simplify consent management and ensure interoperable services.
As the team develops a proposed set of improvements, they will build application programing interfaces (APIs) to enable consent use cases involving privacy, medical treatment, research, and advance care directives.
This project addresses the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT) fiscal year 2019 special area of interest 1: Standardization and Implementation of Scalable HL7 FHIR Consent Resource.
This project began in 2019 and is estimated to be completed in 2022.
The goals of this project are to:
- Create a common FHIR-based authorization framework capable of managing and enforcing patient consent and organizational and jurisdiction policies.
- Review additional privacy- and security-related standards to ensure they support, rather than conflict with, the current FHIR Consent Resource.
- Build and test APIs that enable the use cases and improve patient-centered care, informed consent, and shared decision-making.
- Develop and share a FHIR Consent Implementation Guide and package of open-source prototypes and content to assist partners in using the FHIR Consent Resource.
To find out more about this project and the other 2019 LEAP in Health IT awardee, read the press release.
Mobilizing a Million Hearts: Leveraging Health IT Architecture to Advance Clinical Knowledge and Care Coordination
Understanding how to successfully prompt clinicians at the point of care is a complex problem. For example, there are many clinical decision support (CDS) tools that provide the ability to calculate and display a patient’s updated atherosclerotic cardiovascular disease risk estimate. However, like most risk calculators, these stand-alone tools require clinician activation and do not support coordination of care across providers.
Leveraging Substitutable Medical Applications, Reusable Technologies on Fast Healthcare Interoperability Resources (SMART on FHIR®), MedStar Health Research Institute (MHRI) is working to close the gap between the tremendous promise of data-driven infrastructure supporting clinical knowledge and the current limitations of realized benefits.
MHRI advances clinical knowledge at the point of care by transforming the American College of Cardiology’s (ACC) Million Hearts Longitudinal Atherosclerotic Cardiovascular Disease (ASCVD) risk estimator into an open, standards-based application (app) that seamlessly and securely run across health information technology (health IT) platforms and provider organizations to optimize clinical workflow, improve care coordination, and support patient engagement.
The work represents a multidisciplinary approach that tackled technological and design components of health IT architecture while understanding end-user needs (e.g., cognitive support), workflow, and data integration.
This project addresses the Leading Edge Acceleration Projects (LEAP) in Health IT fiscal year 2018 special area of interest 2: Advancing Clinical Knowledge at the Point of Care.
This project began in 2018 and completed in 2020.
The goals of this project are to:
- Leverage health IT architecture that transforms the Million Hearts® suite of calculators into active cross-platform surveillance CDS that integrates into clinician workflow.
- Address technical challenges associated with shortcomings of current CDS tools, policy challenges, and socio-technical challenges.
- Inform health IT development, research, implementation, and policy by:
- Supporting evidence-based cognitive support,
- Serving as a proof of concept, and
- Facilitating communication and coordination among providers and between providers and patients.
- Build and deploy a SMART on FHIR application (“Mobilizing Million Hearts”) that uses the risk factors of the Million Hearts® Model ASCVD Risk Estimator and incorporates clinician workflow and user needs.
To find out more about this project and the other 2018 LEAP in Health IT awardee, read the press release.