Montreal Connectathon

I would imagine that most readers of this blog are aware of the Connectathons that we hold at the beginning of each Working Group Meeting. These events are critical to the evolution of FHIR as an ‘implementer friendly’ standard, so we love to have as many people present as possible!

Each event is divided into a number of ‘streams’, with each stream exploring some aspect of FHIR – almost always some change that is being proposed to the spec – it’s the opportunity to find out if the proposal is something that should be incorporated into the main spec – or whether it doesn’t really add value. The significance of this is that the Connectathon is based on a ‘ballot candidate’ of FHIR – not the current version. So the version that will be tested at the next Connectathon is the candidate for STU3 which we’re hoping to be able to release at the end of the year.

We’ve got a decent number of streams this time around, so I thought it might be a good idea to list them here. If there’s one that interests you – or that has some impact on work that you are doing – then it will really pay to be there (and hopefully the person who makes the funding decision for you to attend will appreciate that!)

So here are the tracks at this WGM – in alphabetical order. Each track links to the proposal, which describes the track in more detail – this page is just a summary.

CCDA on FHIR. How to create a FHIR document that is analogous to the CCDA standard. This work leverages the DAF (Data Access Framework) Implementation Guide and has as the long term goal the ability to convert between CCDA and FHIR documents.

CDS Enablement Services. This stream explores how to apply SOA principles to support Clinical Decision Support (CDS) within the FHIR framework. Note that we have 3 CDS streams this time – see the next stream and CQF on FHIR.

CDS hooks. This is a proposal from the talented Josh Mandel that describes a standard way for applications to call CDS services. It leverages SMART and more details are here. (We’ve actually done a few posts recently on SMART if you’re interested).

Conditional References. One of the difficulties in a messaging paradigm is how to indicate the reference between resources – eg the Patient to which an Encounter refers. There are ways of doing this at the moment using conditional creates, but it’s a bit klunky, and this stream investigates whether there are better ways of doing this.

CQF on FHIR. This stream is a spike looking both at Decision Support and quality reporting. There’s a lot of detail and references in the proposal, so take a look if quality measurements are important to you.

Data Access Framework (DAF). The DAF Implementation Guide is shaping up to be an important guide internationally. It is essentially a profile (or Implementation Guide) on FHIR that expresses the ‘meaningful use’ information set – but in a computable way. It forms the core of the CCDA work (see above) and is likely to be the guide supported by SMART. It’s also likely to be the ‘base’ guide that other countries start with and adjust to need their specific needs. (see the SMART-ca stream below). This stream exercises both client and server.

Financial Management. Of greatest interest in the US, nevertheless the ability of FHIR to be able to transmit financial and claims based information is going to be an important aspect of information sharing everywhere.

FHIR genomics. Surely one of the hot topics today is how to share genomics information. The genomics workgroup have proposed a new resource (sequence) and a number of profiles on existing resources to support this need. These guys are really organized!

Lab Order Services. Explores the workflow around the ordering of lab tests. There’s another workflow track below – see ‘workflow’ that uses referrals as the use case.

Patch. Explores the issues in ‘patching resources – ie where only partial updates to resources are submitted, rather than a whole new resource.

Patient track. The most important track in the whole event! (Of course, I’m not at all influenced by the fact that I’m the co-ordinator for this…) This is an ‘entry level’ track for those completely new to FHIR who want to find out who easy FHIR is to use. It’s the one track that is not really exercising the standard, but rather allowing people to ‘ease themselves’ into FHIR.

Scheduling and Directory. This track exercises the ability of FHIR to manage appointments, but even more importantly the directory aspects that this involves – for example maintaining and locating services for referrals (which leads to an overlap with the workflow track below). You’ll make my friend Brian Postlethwaite very happy if you do this track…

SMART-ca. We referred to this earlier. This is taking the SMART standard and applying it to a different country – Canada (which is appropriate given that the WGM is in Montreal!). It exercises the DAF IG as well by looking at how to adapt it to a different country. SMART is shaping up to be one of the more important ‘extensions’ to FHIR, so the ability to support different Implementation Guides is going to be really important.

Structured Data Capture. Or the ability to use a standard set of forms to collect and record structured data using the Questionnaire and QuestionnaireResponse resources. In some cases these can be automatically converted into resources. Lloyd is very fond of this track.

Terminology. The ability for FHIR to interact with terminology servers is critically important to the accurate sharing of clinical information – ‘semantic’ interoperability. This track exercises the terminology services defined in FHIR. This is Grahames baby – ’nuff said.

Workflow. The workflow capabilities of FHIR are one of the major focus areas for this release of FHIR. We’re looking to move from an order/OrderResponse protocol, to one in which there is a Task resource which acts as the co-ordinator of the workflow process. In this track we take a referrals scenario, and see if the task is going to meet the business requirements. As mentioned above, there is overlap with the scheduling steam here.

So there we are! A record number of streams to exercise even the most jaded implementer.

I look forward to meeting you in Montreal…