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、联邦和省级政府机构、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，这些提供者在提供病人护理时使用和遵守这些指南。指南开发者可以在电子病历(EMR)软件平台中实施指南，以便更容易地访问护理人员。然而，每个EMR接收和提供指南的方式都不同，这使得指南开发人员很难在每个EMR中实施指南，并确保指南在EMR中一致且适当地呈现。这是至关重要的，因为遵守指南是至关重要的，研究指出，不遵守指南导致了不必要的死亡。项目合作伙伴JuniperCDS(Juniper)是一家数字健康公司，致力于开发名为JuniperCDS的护理和治疗计划(软件)应用程序，这是一个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基于最新临床指南提供上下文建议来创建有意义的、以人为中心的护理计划。JuniperCDS利用HealthLevel7(HL7)快速医疗互操作性资源(FHIR)快速部署基于标准的新指南文档。Juniper还构建了一个名为SAGE的应用程序来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，以确保它是完整的，并符合HL7 FHIR标准。目前，测试指南是一个高度手动的过程，使用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款测试指南的数字测试工具。该工具将使大部分测试自动化，并大大节省时间。莫霍克学院移动健康和电子健康开发与创新中心(MEDIC)是领先的国家数字健康研发中心。医疗保健公司广泛的HL7 FHIR和医疗保健系统集成专业知识创造了与瞻博公司在这个由ARD资助的项目上进行合作的极好的互补伙伴关系。该工具将有助于Juniper的两款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共产品。

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.