Stream: cds hooks/github
Topic: docs / Issue #53 Make Observation suggestion
Github Notifications (Jun 14 2017 at 17:17):
travisstenerson opened Issue #53
One of the issues we are contending with is the fact that occasionally the data we would need to provide complete decision support doesn't exist in neatly structured objects, and probably sits in some unstructured text or somewhere outside the reach of an EHR's FHIR server.
A way we were considering to get around this is a Suggestion card that is basically asking the user to 'make an observation', or more accurately 'structure this Observation in FHIR so we can use it for decision support'. The intention is to suggest this when the service becomes aware that some data should be available - a surgery is complete or a diagnostic report has returned. But this is an extension of the functionality of a suggestion card as we are requesting the user input data, not just select the card. "What was the distance to the closest surgical margin in that excision surgery", or "which histology was noted for the lesion in the biopsy" are examples. Some of these Observations might already be encoded (I'm not sure on how widespread CAP cancer protocols are in EMRs), but from what I understand they usually will not be.
We discussed the idea of sending a 'DataRequirement' in a suggestion card, but I suspect it this would be complicated for the EHR and require some pre-arranged agreement on the interpretation of a DataRequirement, removing the vendor agnostic aspect that is so attractive about CDS-Hooks.
Has anyone else thought about this sort of issue? Of course with SMART app interaction we can simply prompt the user and then return the structured Observation with the decisions. But for a situation where the doctor is viewing the pathology report and we have the opportunity to structure otherwise unstructured data, a suggestion card might be ideal. Structuring unstructured data is an issue in health informatics in general, and CDS-Hooks might allow a minimally intrusive way to ask a user to do so.
Last updated: Apr 12 2022 at 19:14 UTC
