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

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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.