HSPC and Cognitive Medical Systems Push the Limits of Standards-based Clinical Decision Support
One goal of developing open standards for the exchange of electronic health information is to break down the proprietary silos dominating the health IT industry and allow for greater interoperability of data, processes, and domain knowledge. In clinical decision support specifically, standards help ensure transparent access to the patient’s complete medial record in a format that is amenable to machine aggregation, analysis, and processing. Until recently those seminal standards have existed in a vacuum.
Individual, isolated services are not very effective tools in solving real-world clinical problems. However, an easily configured platform built to deploy multiple, well-orchestrated HL7 services could fundamentally change healthcare. In March, the Healthcare Services Platform Consortium (HSPC) demonstrated such a platform at the Healthcare Information and Management Systems Society (HIMSS) 2016 Conference & Expo in Las Vegas, Nevada.
“The HSPC Clinical Decision Support demonstration illustrated that while many HL7 Services are still immature and functionally incomplete, it is still possible to combine them into architecture capable of delivering real clinical value,” says Emory Fry, MD, Cognitive Medical Systems’ CEO. “Cognitive envisions a day in the near future where such standards-based architecture will be viewed as ‘plumbing’ and innovators will be free to move on to more interesting,knowledge management applications and functional capabilities.”
Working in collaboration with Intermountain Healthcare, the University of Utah, Health Samurai, and the Regenstrief Institute, Cognitive showcased how HL7 services could be used to help provide optimal care for an automobile accident victim while hospitalized in an Intensive Care Unit. The scenario included a use case in which complex event processing detected clinically important fluctuations in systolic blood pressure—that would not normally trigger bedside monitor alarms—and determine whether these anomalies were associated with medication administrations and/or early onset sepsis. By incorporating the patient’s genomic profile, the system provides enhanced therapeutic advice based on their predisposition to certain medication side effects.
The demonstration orchestrated services based on several HL7 standards (Fast Health Information Resources [FHIR], Decision Support Service [DSS], Unified Communications [UCOM] and Event Publish & Subscribe [EPS]) to create and deliver real-time CDS advice to providers at the bedside. It also illustrated advanced capabilities such as dynamic routing alerts using different communication channels (email, SMS, etc.) and escalation of advice to alternative recipients.
“The HSPC demonstration highlights that standards are maturing rapidly and are even today capable of supporting some very complex clinical requirements,” said Fry.
