Overview of Argonaut Initiatives - FHIR DevDays€¦ · Overview of Argonaut Initiatives Brett Marquard, WaveOne . Instructor Brett Marquard Principal, WaveOne Associates Extensive

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Overview of Argonaut Initiatives

Brett Marquard, WaveOne

Instructor

Brett Marquard

• Principal, WaveOne Associates

• Extensive EHR experience

• Primary Editor, Consolidated CDA (C-CDA)

• Primary Editor, Argonaut Data Query IG / US FHIR Core IG

• [email protected]

Outline

Background on Argonaut

Key Prior Initiatives

• SMART on FHIR support

• Data Query and Document Query

• Scheduling

• Provider Directory

• CDS Hooks support

Future

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What is the Argonaut Project?

The Argonaut Project is an implementation community comprising leading

technology vendors and provider organizations to accelerate the use of FHIR and

OAuth in health care information exchange.

We are:

• Private sector initiated and funded

• Working collaboratively with other FHIR initiatives such as SMART-on-FHIR, the Health

Systems Platform Consortium, and the FHIR Foundation

• Creating open industry Implementation Guides in high priority use cases of importance to patients, providers and the industry as a whole

We are NOT:

• A standards development organization

• A separate legal entity

• A proprietary activity

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Technology Vendors Provider Organizations

• Accenture • Beth Israel Deaconess Medical Center

• Apple • Intermountain Health

• athenahealth • Mayo Clinic

• Cerner • Partners Healthcare

• Epic • SMART at Boston Children’s Hospital • Change Healthcare

• MEDITECH

• Surescripts

• The Advisory Board Company/Optum

Staff (current and past)

• Prime contractor: HL7

• FHIR initiatives: Grahame Grieve, Josh Mandel, Brett Marquard, Eric Haas

• OAuth initiatives: Dixie Baker, Josh Mandel

• Project Management: Micky Tripathi, Jennifer Monahan

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Argonaut Project Timeline

JASON Task Force

Recommendations

Oct 2014 Dec 2014 Oct 2015

Call to action for

APIs and FHIR

Launch of

Argonaut Project

EHR certification

includes API requirement

Dec 2016

S&I Initiative

Data Access

Framework

Data Query

Implementation Guide published

Provider Directory

Implementation Guide published

Jun 2017 Mar-May 2018

Scheduling Implementation Guide

CDS Hooks Implementation Guide

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Four Short Years from Inception to Market Adoption

50% of 100+ certified

vendors use FHIR APIs

Jan 2018

CommonWell includes

Argonaut FHIR specifications in core services – MEDITECH goes live on FHIR

Carequality implements

Argonaut Provider Directory specifications

Apple enables secure iPhone

access to medical records using Argonaut

Implementation Guide

Prior Argonaut Initiatives

SMART on FHIR support

Data Query and Document Query

Provider Directory

Scheduling

CDS Hooks support

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SMART on FHIR Support

When

Summer 2015

What SMART Health IT is an open, standards based technology platform that enables innovators to create apps that seamlessly and securely run across the healthcare system. SMART on FHIR provides reliable, secure authorization for a variety of app architectures through the use of the OAuth 2.0 standard.

Outcomes • Application Authorization Profile available: http://docs.smarthealthit.org/authorization/

• Use Cases Description, Version 1.1 available: http://argonautwiki.hl7.org/images/4/4c/Argonaut_UseCasesV1.pdf

• Security Risk Assessment: http://argonautwiki.hl7.org/images/e/ed/%282015May26%29RiskAssessment_ReportV1.pdf

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https://smarthealthit.org/

http://www.hl7.org/fhir/smart-app-launch/

Data Query and Document Query

When ~2015 - 2017

What Guidance to meet the 2015 Edition certification criterion for Patient Selection 170.315(g)(7) and Application

Access – Data Category Request 170.315(g)(8). The Argonaut Data Query Implementation Guide is based upon

the core FHIR DSTU2 API. Original work built on the Data Access Framework (DAF).

Use Cases This specification describes four use cases and sets search expectations for each. For complete details and

background, see Use Cases for the Argonaut Project:

1. Patient uses provider-approved web application to access health data

2. Patient uses provider-approved mobile app to access health data

3. Clinician uses provider-approved web application to access health data

4. Clinician uses provider-approved mobile app to access health data

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Data Query and Document Query

Outcomes • Published Data Query guide: http://www.fhir.org/guides/argonaut/r2/

• Published DocumentReference profile: http://www.fhir.org/guides/argonaut/r2/StructureDefinition-argo-documentreference.html

• Guidance on ‘Must Support’, free text units, vocabulary binding: http://www.fhir.org/guides/argonaut/r2/definitions.html

• Implementation: many Argonaut vendors support FHIR according to Argonaut DSTU2

…oh, and US Core

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US FHIR Core

The US FHIR Core is a labeled subset of all HL7 US-Realm produced FHIR profiles.

The label is designed to provide the community with a single point of reference to

foundational US FHIR profiles that:

1) should be used by US stakeholders when implementing FHIR; and

2) always be used as the basis for creating further US-Realm profiles.

Bottom line • Argonaut IG = US Profiles on DSTU2

• US Core = HL7 balloted US Profiles on STU3

Future • Argonauts – encouraged to use US FHIR Core rather than writing their own FHIR STU3 guide.

• US Core – discussions at HL7 US Realm Steering Committee to add new profiles to US Core, such as Clinical Notes.

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For more details checkout

Data Query US Core

Today 6/20 at 14:20

Provider Directory

When

2016

What The Argonaut project Provider Directory guide is based upon the FHIR STU3 API and contains the foundation for a robust provider directory. It describes the use cases and search expectations for finding a practitioner or organization. It outlines the key data elements for any provider directory and basic query guidance.

Outcomes • Published Implementation Guide: http://www.fhir.org/guides/argonaut/pd/

• Developed organization relationship guidance: http://www.fhir.org/guides/argonaut/pd/guidance.html

• Carequality Implementation

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Provider Directory Use Cases

Search for Practitioner by demographics • Name • Specialty

Search for Practitioner within a region (city, state) • Practitioner or specialty within a specified distance - 10 miles from patient home • Show me every one of this specialty in the city

Search for Organization and facility by: • Name • Address

Search for Practitioner by organizational relationships • Practitioner in a specific health organization (e.g. Baptist Health Organization) • Practitioner in a specific clinic (e.g. West Clinic)

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Patient and Provider Scheduling

When

2017

What The Argonaut Scheduling Project is a vendor agnostic specification providing FHIR RESTful APIs and guidance for access to and booking of appointments for patients by both patient and practitioner end users. This specification is based on FHIR Version 3.0.1 and specifically the Scheduling and Appointment resources.

Outcomes • Published Implementation Guide: http://www.fhir.org/guides/argonaut/scheduling/

• Several new Scheduling operations: http://www.fhir.org/guides/argonaut/scheduling/operations.html

• Implemented by a subset of Argonaut participants

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For more details checkout

The Argonaut Scheduling

Project session

Thursday 6/21 at 09:00

CDS Hooks Support

When

2017 - 2018

What A vendor agnostic remote decision support specification.

The specification describes a "hook"-based pattern for invoking decision support from within a clinician's EHR workflow. The API supports: Synchronous, workflow-triggered CDS calls returning information and suggestions, Launching a user-facing SMART app when CDS requires additional interaction.

Outcomes • Supported march to CDS Hooks 1.0 (currently under HL7 ballot): http://cds-hooks.org/specification/1.0/

• Quick Start guide: http://cds-hooks.org/quickstart/

• Security Risk Assessment

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CDS Hooks

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CDS Hooks 1.0

http://cds-hooks.org/specification/1.0/ 18

CDS Hooks Sandbox

http://sandbox.cds-hooks.org/ 19

Setting Priorities for 2018

Once a year the sponsors brainstorm and select projects

10+ were suggested at end of 2018

Broad categories for 2018

- New FHIR profiles

- Administrative use cases

- Additional app integration guidance

- Continue advancing prior initiatives

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Argonaut Project 2018 Projects

1. Clinical Notes

• Shouldn’t there be a Common Clinical Note Set to accompany the Common Clinical Data Set?

2. Bulk Data Access to Clinical Data

• A roster of patients rather than one patient at a time

3. Simple Assessment Questionnaires

• Import from external experts and capture/export data consistently

• Implement custom assessments across disparate systems and aggregate responses

Selected 2018 Priorities

Bulk Data + Back-end Services authorization - Josh Mandel/Dan Gottlieb

Clinical Notes - Brett Marquard/Eric Haas

Questionnaire & Questionnaire Response - Eric Haas/Brett Marquard

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https://github.com/argonautproject

Bulk Data

December 2017 ONC Meeting on Bulk Data

January 2018 SMART Bulk Data Reference Implementation Server

Initial Connectathon for interested parties to start experimenting with proposed technical

specification

2018 FHIR Connectathon events to refine and develop the technical specification

Argonaut Project to bring together pilot implementations

Publish Draft Implementation Guide

2019 Publish version 1.0 of FHIR Implementation Guide For Bulk Data

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https://github.com/smart-on-fhir/fhir-bulk-data-docs/

Clinical Notes Timelines

March 2018 Launch!

April – May 2018 May connectathon scenarios

5/12 - 5/13: HL7 Connectathon at Cologne Working Group

Review outcomes from May connectathon

Summer 2018 Argonaut Stakeholder review of IG

Develop additional examples

Determine interest in pushing recommendations into US Core STU4

Sept 2018 FHIR Connectathon events to refine and develop the technical specification

Fall 2018 Updates from connectathon

Support US Core STU4 ballot reconciliation or hand over to HL7

Winter 2018 Published IG

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https://github.com/argonautproject/clinicalnotes

Questionnaire & Questionnaire Response

April 2018 Argo Questionnaire Kickoff

Refine Scope

Define Content and technical Specifications for Draft Implementation Guide

Summer 2018 Initial Connectathon for interested parties to start experimenting with proposed technical

specification

Publish and refine Draft IG

Sept 2018 FHIR Connectathon events to refine and develop the technical specification

Fall 2018 Publish and refine Draft IG

January 2019 Published IG

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https://github.com/argonautproject/questionnaire

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Participation

Review existing designs and comment use issues on GitHub

Zulip Chat Channels

• Bulk Data

• Argonaut

Upcoming HL7 Connectathon in Baltimore, MD (9/29 - 9/30)

Contact

• Eric Haas

• Josh Mandel

• Brett Marquard

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