Stream: workflow
Topic: Protocol
Oliver Krauss (Apr 20 2016 at 11:43):
Repost from Implementers/OrderSet since hopefully this stream takes off!?
Hello, I have questions concerning OrderSet/Protocol.
Should Protocol/OrderSet also support organizational processes such as tumor boards or is there a different Resource planned for this?
Should we think about process-abstraction? For example re-usable process steps/activities in Protocol, similar to how ActionDefinition is reusable in OrderSet. To my recollection we didn't talk about reusability yet in the workflow-calls.
Lloyd McKenzie (Apr 20 2016 at 13:44):
The current thought (yet to be validated by CDS) is to take DecisionSupportRule and make that the reuseable structure for "process step". ActionDefinition will get collapsed into that, at least for now. (We need some real experience or significant feedback about where re-use is actually useful.)
Lloyd McKenzie (Apr 20 2016 at 13:44):
You'll have to explain "tumor boards" and how those relate to the notion of Protocol. Certainly Protocol is not going to be constrained to activities focused on patients.
Oliver Krauss (Apr 25 2016 at 15:00):
Okay thanks for the info. That is definitely the direction we are thinking too. What is important in ActionDefinition is to allow branching (not yet supported I think), similar to nextStep in Protocol.
Concerning "tumor board" I am talking about the multi disciplinary team meeting. Tumor board is a special MDTM concerning oncology. In the board treatment suggestions for patient cases are made by professionals of mutliple disciplines.
How this connects to protocol in my mind is a definition of how the tumor board should be conducted (who, as in what professions, gets invited; what patient cases will be discussed; what guidelines for treatment exist; ...). Currently there are some guidelines in place on these matters, and hospitals have an internal process-definition (eg. in BPMN) which could be modeled as protocol in FHIR.
Lloyd McKenzie (Apr 25 2016 at 20:14):
I think Protocol could be used to define "how a tumor board meeting should occur" if that were useful.
Paul Knapp (Apr 26 2016 at 13:30):
So Protocol doesn't conform to or support the notion of a Treatment Protocol?
Lloyd McKenzie (Apr 26 2016 at 15:45):
It supports the notion of any type of protocol - study, treatment, equipment maintenance, whatever. Any situation where you want to define a set of activities that can occur and the relationships between them in terms of sequence, pre-requisites, decision-points, etc.
Reinhard Egelkraut (Jul 14 2016 at 16:19):
I have a question concerning the protocol resource:
I was following a zulip conversation from the decision support work group and during that discussion Bryn Rhodes mentioned that the protocol resource will be replaced by a new resource called PlanDefinition:
https://chat.fhir.org/#narrow/stream/implementers/subject/Decision.20Support.2FQuality.20Measurement/near/26287
Is that really the case?
Lloyd McKenzie (Jul 14 2016 at 17:46):
That's the plan, yes.
Lloyd McKenzie (Jul 14 2016 at 17:47):
Do you have concerns @Reinhard Egelkraut
Reinhard Egelkraut (Jul 14 2016 at 18:16):
No, I don't have any concerns so far, I was just suprised by the change since I can't remember that it came up in the workflow calls.
Nevertheless the struture looks similar and I think removing the step part from the original protocol resource and focusing on the actionDefinition reduces the complexity. The new resource PlanDefinition still fits our purposes (which is the tumorboard solution @Oliver Krauss mentioned earlier in this stream), so at least from our point of view the change is good.
Although it would be interesting to know the exact reasons for the change, @Lloyd McKenzie do you by chance have the minutes from the call or meeting in which the decision was made?
Lloyd McKenzie (Jul 14 2016 at 21:28):
@Reinhard Egelkraut It was quite a while ago. (I'm horribly behind at getting minutes posted, but I think it was even before that - Bryn was on the call and it was discussed significantly on the CDS/CQI calls (who are responsible for the resource). So it wasn't really a decision by the Workflow taskforce, but rather by CDS with recommendations from the Workflow taskforce.
Lloyd McKenzie (Jul 14 2016 at 21:28):
(It was also discussed informally and formally a bit in Montreal.)
Last updated: Apr 12 2022 at 19:14 UTC
