An Architecture for CDS and Quality Measurement

1September 2013

An Architecture for CDS and Quality Measurement

September 2013

2September 2013

Architecture

The manner in which the components of a computer or computer system are organized and integrated-- Merriam-Webster Online Dictionary

3September 2013

Building Architectural Components

4September 2013

HL7 (SAIF) Architectural Components

5September 2013

SAIF in Simple Terms

Viewpoints Business Requirements

Information Models

Behavioral Models Engineering & Technology

Specifications

Conceptual Scope, Problem Statement, Story Boards, Use Cases

Domain Analysis Model, Clinical Statement Pattern

Functional Specs, Service Roles & Relationships, Application Roles & Interactions

Compatibility, Existing Platforms, Design Patterns

Platform Independent

Authorities and Alignments, Core Principles, Priorities, Methodology

Logical Models Collaboration Patterns, Interface / Service Specifications (e.g., WSDL)

Existing Models, Libraries, Intended Transparencies*

Platform Specific

Rules, Procedures Physical Models, Schemas

Scripts, Orchestrations, Interface Implementations

APIs, Protocols, Transforms, ITS, Deployment Models

6September 2013

SAIF in Simple Terms

Viewpoints Business Requirements

Information Models

Behavioral Models Engineering & Technology

Specifications

Conceptual QI Whitepaper QI DAM QI Functional Requirements

Product List

Platform Independent

QI D-MIM QI Logic Expression Transparency Principles

Platform Specific

QRDA, HQMF, HeD Knowledge Artifact, VMR, CCDA R2?

HeD Knowledge Artifact, HQMF

Common Metadata

QI Policy

7September 2013

*Transparent = Invisible

Transparency What it Makes Invisibleaccess differences in data representation and

procedure calling mechanism location physical addresses, including the distinction

between local versus remotemigration & relocation

relocation of an object

persistence deactivation and reactivation of an objectfailure failure and possible recovery of objectsreplication maintenance of consistency between replicastransaction coordination of transactions

8September 2013

What is a Template

A set of constraints on a model. Further refines existing models to narrow scope. Represented by a formal definition. Used to validate instances.

Summarized from HL7 Templates DSTU and Ballot Draft

9September 2013

What is Metadata

Used to Find & Manage Things [Governance]SubjectProvenanceSecurity & PrivacyDescriptiveExchangeObject LifecycleRelationships-- See Healthcare Metadata

10September 2013

HL7 Specifications Related to Quality Improvement

VMR for CDS Logical Model VMR for CDS Templates VMR for CDS XML Implementation Guide HED Knowledge Artifact Implementation Guide Decision Support Service Implementation Guide HQMF Specification HQMF QDM-Based Implementation Guide CCDA Specification QRDA Specification Arden Syntax GELLO InfoButton QDM XML ITS (1 & 2) Data Types RIM Clinical Statement Pattern

11September 2013

Reverse Engineering a Product Architecture

1. Specification Teardown2. Overlaps and Gaps3. Similarities and Differences4. Identify Opportunities5. Agree to disagree, or to work it out6. Plan the Journey Ahead

12September 2013

Specification Teardown

Using your PSS and SpecificationWrite down the Spec Name on several Post-it Notes Identify SAIF Components in your Spec/PSSPut it up on the chartRepeat until DoneDon’t Sweat the Small Stuff

13September 2013

Overlaps & Gaps, Similarities and Differences

Identify OverlapsIf two components are similar, put them

closer together.If different, farther apart.Is anything missing? Are you sure?Look for hidden assumptions

14September 2013

Opportunities and Variations

What’s the low hanging fruit?Successes? Failures?What Variations are OK? Not?How long will it take to fix?

15September 2013

Plan and Prioritize

What can be delivered by November for Ballot, or January for Publication

What needs more time?Where will the puck be …

In 6 months? In 12 months?

How do we get there? What is the path of least regret?

16September 2013

Questions?

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