Stream: implementers
Topic: ccow
Jens Villadsen (Aug 29 2016 at 12:09):
Is there anyone who has done the crazy thought of thinking about doing a FHIR CCOW implementation / draft - meaning not only the authentication/authorization part ... but also keeping the subjects in question mapped as FHIR?
John Moehrke (Aug 29 2016 at 12:15):
There have been informal discussions. Closest today is the looser-coupling that SMART has defined.
John Moehrke (Aug 29 2016 at 12:16):
That aside, the HTTP flavor of CCOW should work fine.
Jens Villadsen (Aug 29 2016 at 12:16):
HTTP flavor works fine ... However the subject mapping is pretty clunky
Grahame Grieve (Aug 29 2016 at 12:17):
Josh and I have talked about a ongoing client/server context sync for Smart on FHIR, but it's not clear that this is a right diretion to pursue - it'll never be a replacement for full CCOW, so is it worth being a half equivalent?
Jens Villadsen (Aug 29 2016 at 12:19):
From what I hear among my fellow clinicians, full CCOW, or at least a standardized way of jumping between applications with the current subject in mind is very much needed
John Moehrke (Aug 29 2016 at 12:19):
The abstract model for CCOW is possible to apply to a more FHIR based data model. That would make Patient look okay. But the interaction model and relationship to the data storage might require a new implementation-model.
John Moehrke (Aug 29 2016 at 12:20):
Full CCOW model is a counter model to a HTTP RESTful -- which is predominantly loosely-coupled and stateless.
Grahame Grieve (Aug 29 2016 at 12:20):
@Josh Mandel - alert for your consideration...
Jens Villadsen (Aug 29 2016 at 12:22):
a stateless model could be constructed for a CCOW-light version, only handling the 'jump-to-this-application with this patient in mind'
Jens Villadsen (Aug 29 2016 at 12:23):
meaning that the ccow server should be aware of what other applications are running
Jens Villadsen (Aug 29 2016 at 12:23):
this is however not full CCOW ... but it is highly usefull
John Moehrke (Aug 29 2016 at 13:09):
Jens, that is what SMART does today.
Jens Villadsen (Aug 29 2016 at 13:44):
@John Moehrke Haha ... now that you are saying it
Jens Villadsen (Aug 29 2016 at 13:45):
However ... as I read it on https://fhirblog.com/2016/07/08/what-is-smart-and-why-should-you-care/ ... it only goes one way.
Jens Villadsen (Aug 29 2016 at 13:45):
But that might just be a detail?
Jens Villadsen (Aug 29 2016 at 13:45):
I would like to launch an application with a given context ... SMART gives me that
Jens Villadsen (Aug 29 2016 at 13:46):
Now, from that launched application, I would like to open another application ... with whatever (context/patient) I give it
John Moehrke (Aug 29 2016 at 13:46):
Yes that is all that SMART does, but that is all you asked for right before I posted that. This is only a beginning.
John Moehrke (Aug 29 2016 at 13:47):
It is not coordinated, it is just -startup context.
Jens Villadsen (Aug 29 2016 at 13:48):
So is the intent that you can jump from application to application with whatever context you pass on ... or is it thought to more of a star topology ... meaning that you launch all other applications from a single application?
John Moehrke (Aug 29 2016 at 13:49):
Best to take this to the smart stream. One perspective of a master, is another perspective of a star...
Jens Villadsen (Aug 29 2016 at 13:53):
that sounded pretty philosophical
Grahame Grieve (Aug 29 2016 at 13:53):
John is the master...
Jens Villadsen (Aug 29 2016 at 13:53):
... of philosophical statements
John Moehrke (Aug 29 2016 at 13:54):
:-)
Jens Villadsen (Aug 29 2016 at 13:56):
now you mentioned the smart stream ... I can't seem to see one on Zulip
Jens Villadsen (Aug 29 2016 at 14:37):
hmmm .... okay ... so anyone want to join in on the fun of doing a FHIR port of this? ;) https://github.com/jkiddo/ccow (which is usual CCOW + some web socket extensions).
Josh Mandel (Aug 29 2016 at 15:25):
On the subject of launching apps from within apps: we have a general discussion about how SMART app should be able to communicate back to the EHR. We've identified four use cases at the top of https://github.com/smart-on-fhir/smart-on-fhir.github.io/wiki/thoughts-on-inter-app-communication
Jens Villadsen (Aug 29 2016 at 21:45):
OK - continuing this on the stream:smart topic:CCOW
Jens Villadsen (Aug 30 2016 at 11:32):
A question: Having read about SMART and this discussion one thing comes to my mind.
Is SMART thought to take over/replace CCOW in the long run - or would it be the right time to start thinking about Clinical Context Object Sharing (CCOS) - a modern CCOW standard replacement using many of the CCOW concepts but with multiple devices having the same user in mind, sharing context across apps and devices?
Jens Villadsen (Aug 30 2016 at 11:32):
where objects are modelled according to FHIR
Grahame Grieve (Aug 30 2016 at 11:33):
In principle, this would be in scope for consideation.
Jens Villadsen (Aug 30 2016 at 11:33):
using web-sockets for near realtime event notifications
Jens Villadsen (Aug 30 2016 at 11:34):
for scope for consideration of SMART or for a new standard (which I just called CCOS)
Jens Villadsen (Aug 30 2016 at 11:34):
?
Grahame Grieve (Aug 30 2016 at 11:34):
on the other hand, there's been very little interest in CCOW at HL7 generally, and I'm not sure how you could overcome the inertia that it's apparent lack of interest establishes
Jens Villadsen (Aug 30 2016 at 11:35):
lets say CCOS would have a heavy userbase in nothern europe
Jens Villadsen (Aug 30 2016 at 11:35):
because almost all information is already synchronized on the backend
Grahame Grieve (Aug 30 2016 at 11:35):
in scope for FHIR generally - to define a context object, and for it to be used for this purpose. I'm not sure how it might relate to Smart on FHIR
Grahame Grieve (Aug 30 2016 at 11:36):
well, you should establish first what the usage of CCOW is. This is a standard that we couldn't find anyone to endorse last year....
Jens Villadsen (Aug 30 2016 at 11:37):
it caused some drama here in DK when the it was rumoured it was to be deprecated
Jens Villadsen (Aug 30 2016 at 11:37):
or whatever the wording was
Jens Villadsen (Aug 30 2016 at 11:38):
eventough noone implements it
Jens Villadsen (Aug 30 2016 at 11:38):
but it has focus ... little attention has been drawn to the area of usability across multiple applications
Jens Villadsen (Aug 30 2016 at 11:39):
until now
Jens Villadsen (Aug 30 2016 at 11:39):
my statements are based on Danish experience
Jens Villadsen (Aug 30 2016 at 11:40):
I would love to start up on it ... but if noone has interest in it ... well ... then it will just be the thoughts of a crazy dane
Jens Villadsen (Aug 30 2016 at 11:41):
I think I have some people near me who would contribute to the work
Jens Villadsen (Aug 30 2016 at 11:42):
And it could ride on the FHIR-attention-wave
Jonathan Bunde-Pedersen (Aug 30 2016 at 11:43):
I'd be close to you and interested in participating ;)
Jens Villadsen (Aug 30 2016 at 12:32):
we'll continue on smart/ccow
John Moehrke (Aug 30 2016 at 16:28):
Seems really odd that it is up to healthcare to invent a web application context infrastructure, rather than just defining the context schema... Begs many questions....
Grahame Grieve (Aug 30 2016 at 20:42):
is there anything else then?
Paul Knapp (Aug 31 2016 at 06:50):
I think INM is now the custodian of CCOW, I suggest you raise it with them. If there is a community of interest then I expect they'd support.
Pascal Pfiffner (Aug 31 2016 at 14:30):
+1 for FHIR/Context. Has this been started by anyone?
David Hay (Sep 05 2016 at 02:14):
Hey Josh: what's the relationship with these thoughts & CDS hooks?
David Hay (Sep 05 2016 at 02:15):
https://github.com/smart-on-fhir/smart-on-fhir.github.io/wiki/thoughts-on-inter-app-communication
Josh Mandel (Sep 05 2016 at 04:22):
These thoughts are about how a running app communicates with the EHR. CDS Hooks is about how to call a service from within an EHR session. So they're distinct, in my mind. (But if you have CDS Hooks, you can address some use cases by avoiding the need to launch a full-on app.)
Brian Postlethwaite (Sep 06 2016 at 01:04):
I always thought of cdshooks as apps letting others know what is going on.
And the receiver of the notification provides feedback.
Where ccow is more or less the same, just informative, i.e. no feedback channel.
Last updated: Apr 12 2022 at 19:14 UTC
