Investigation and Development of an Automated Testing Platform for Digitally Implemented Clinical Guidelines in the HealthLevel7 (HL7) Fast Healthcare Interoperability Resources (FHIR) Standard

医疗保健研究人员、联邦和省政府机构、专业协会和独立组织为护理提供者（例如医生和护士）制定和更新临床指南，他们在提供患者护理时使用和遵循这些指南。指南开发人员可以在电子医疗记录（EMR）软件平台中实现指南，以便于护理提供者访问。然而，每个EMR以不同的方式摄取和呈现指南，这使得指南开发人员在每个EMR中实现指南并确保指南在EMR中一致且适当地呈现具有挑战性。这一点至关重要，因为遵守准则至关重要，研究指出，不遵守准则已导致不必要的死亡。项目合作伙伴JuniperCDS（Juniper）是一家数字医疗公司，正在开发一种名为JuniperCDS的护理和治疗计划（软件）应用程序，这是一种临床决策支持软件解决方案，使临床医生能够通过在护理点提供基于最新临床指南的上下文建议来创建有意义的，以人为本的护理计划。JuniperCDS利用HealthLevel7（HL7）快速医疗保健互操作性资源（FHIR）快速部署基于标准的新指南文档。瞻博网络还构建了一个名为SAGE的应用程序，以帮助创建这些可计算的指南。临床指南数字化实施的一个主要挑战是测试指南，以确保其完整并符合HL7 FHIR标准。目前，测试指南是一个高度手动的过程，只有最少的难以使用的现有工具。通过这个项目，Juniper希望抓住机会开发一个数字测试工具来测试准则。该工具将自动化测试的主要部分，并提供显着的时间节省。莫霍克学院mHealth和电子健康发展和创新中心（MEDIC）是一个领先的国家数字健康研究和开发中心。MEDIC广泛的HL7 FHIR和医疗保健系统集成专业知识与Juniper在这个ARD资助的项目上建立了良好的互补合作伙伴关系。该工具将有助于Juniper的两个应用程序的转型和发展。在外部，测试工具将在完成后立即免费提供，作为测试和验证数字化指南的全球公益物。

Healthcare researchers, federal and provincial government agencies, professional societies and independent organizations develop and update clinical guidelines for care providers (e.g. doctors and nurses), who use and follow those guidelines when providing patient care. Guideline developers can implement guidelines in electronic medical record (EMR) software platforms for easier care provider access. However, each EMR ingests and presents guidelines differently, which makes it challenging for guideline developers to implement guidelines in each EMR and to ensure the guidelines are presented consistently and appropriately across EMRs. That is essential, since guideline compliance is critical, with studies noting that non-compliance has resulted in unnecessary deaths. The project partner, JuniperCDS (Juniper), is a digital health company that is working on developing a care and treatment planning (software) application called JuniperCDS, which is a clinical decision support software solution that enables clinicians to create meaningful, person-centric care plans by delivering in-context recommendations based on the latest clinical guidelines at the point of care. JuniperCDS leverages HealthLevel7 (HL7) Fast Healthcare Interoperability Resources (FHIR) to rapidly deploy new standards-based guideline documents. Juniper has also built an application, called SAGE, to help create those computable guidelines.A major challenge with clinical guideline digital implementation is testing the guideline to ensure it is complete and meets HL7 FHIR standards. Currently, testing a guideline is a highly manual process with minimal existing tools that are difficult to use. With this project, Juniper would like to seize the opportunity to develop a digital testing tool that tests guidelines. The tool will automate a major portion of the testing and provide significant time savings.The Mohawk College mHealth and eHealth Development and Innovation Centre (MEDIC) is a leading national digital health research and development hub. MEDIC's extensive HL7 FHIR and healthcare system integration expertise creates an excellent complementary partnership to collaborate with Juniper on this ARD-funded project. The tool will help to transform and evolve both of Juniper's apps. Externally, the testing tool will be made available immediately for free upon completion as a global public good for testing and validating digitized guidelines.