Stream: implementers
Topic: EMR and FHIR integration
scott white (Nov 19 2017 at 15:58):
I am interested in using FHIR with an EHR (Cerner, Allscripts, Epic) that provides the following functionality:
• Phase 1 - Button in the EMR workflow (home screen) that collects physician info (UPIN#, office address) and then sends the information to a 3rd party, enrollee application/dbase. Currently this enrollment is done via the Web and a URL. I want this to be seamless to the physician and all completed from within the EMR (with interoperability)
• Phase 2 (future)– invoke the enrollment process at the time a specific medication type is ordered. Display a message asking whether the physician needs to enroll, and if they choose “yes”, invoke a FHIR or other process to collect their data via a form and send this to the enrollee application/dbase
I have some questions that I am hoping I can get some guidance on:
For Phase 1
• Can a button be used and configured on the EMR to initiate FHIR and or a Smart APP? How would I present a form with questions to the physician and then what would be the technical processes used to “share” this information with the remote, enrollee database (web application)? FHIR, SMART App, both, or other?
• Are there any current FHIR resources or workflow that could be used for the prescriber enrollment function described above? Which one’s? Are the resources or workflow supported as part of the current FHIR release (DSTU 3)? I was looking at enrollmentRequest but that is for insurance and level 0/draft at this time.
For Phase 2
• Are there ways on the EMR to conditionally invoke a SMART App or FHIR? I read about CDS hooks and the Medication-Prescribe hook but I can’t find whether this is currently available and for what EMR’s. Any ideas on support and availability of these hooks?
• If the CDS hook is available, I would want to prompt the physician and ask whether they need to enroll. Is this done using the SMART App card?
• Once the decision to enroll is made, how can I use FHIR to collect data fields (physician info only and no patient/other info) and exchange this info with the Enrollee database? The questionnaire seems like one option but is this supported and how exactly would this be used with FHIR to write to the enrollee database?
I can send a workflow that may help describe this better. Thank you
Kevin Shekleton (Nov 19 2017 at 17:53):
Hi @scott white - I answered your CDS Hooks questions over in our #cds-hooks stream
Kevin Shekleton (Nov 19 2017 at 17:58):
Regarding your Phase 1 questions, the three vendors you mentioned support SMART on FHIR apps within the EHR and can be launched with a button click.
As for reading FHIR data from the EMR, each of the vendors have different capabilities so you'll want to check with each to see if they have the data you are interested in. Each of those three vendors are members of the Argonaut Project so there is quite a bit of common capabilities/FHIR data each supports. With respect to sending data to the enrollee application/database, your SMART app should be able to write data to your own database.
Last updated: Apr 12 2022 at 19:14 UTC
