. 2012 Nov 3;2012:446–455.

Table 2.

Capabilities provided by a CIS that enable a SOA for CDS.

Capability	Description, Example Use Case, and Relevant Standards
Use of Appropriate, Standard Information Models and Terminologies Source: HL7 CDS Work Group, literature¹¹,¹⁴,¹⁷,²⁰,²⁷,³⁴	Description: Appropriate, standard information models and terminologies are used to instantiate data in the payloads of various services. Use case: A Clinical Data Query Service uses a standard information model to represent the data it provides. Relevant standards: HL7 version 2 and 3 messaging standards; HL7 Virtual Medical Record standard; IHE profiles; HITSP standards; OpenEHR templates; Detailed Clinical Models; SNOMED CT; LOINC; ICD; CPT; various others.
Ability to Leverage a DSS Source: HL7 CDS Work Group, literature¹¹,¹³,¹⁴,¹⁷,¹⁸,²⁴,²⁶,³¹,³⁴–³⁸,⁴⁰–⁴²	Description: The CIS is able to use a DSS to obtain patient-specific care assessments and recommendations. Use case: The disease management module of an EHR system uses a DSS to obtain diabetes care recommendations based on national guidelines. Relevant standards: HSSP¹⁹ Decision Support Service standard; IHE Request for Clinical Guidance profile.
Ability to Leverage a Terminology Service Source: HL7 CDS Work Group, literature¹¹,²⁴,³⁷	Description: The CIS is able to use a service to fulfill terminology needs. Use case: A CIS uses a terminology service to convert internal laboratory codes into the LOINC codes required by a DSS. Relevant standards: HSSP¹⁹ Common Terminology Services 2 standard.
Ability to Leverage a Unit Conversion Service Source: HL7 CDS Work Group, literature³⁸	Description: The CIS is able to use a service to convert units. Use case: A CIS uses a unit conversion service to convert laboratory units used by the local CIS into the different laboratory units required by a DSS. Relevant standards: The Unified Code for Units of Measure (http://aurora.regenstrief.org/~ucum/ucum.html).
Ability to Leverage a Data Transformation Service Source: HL7 CDS Work Group, literature¹¹,²⁴	Description: The CIS is able to use a service that maps data represented using one information model into data represented using a different information model. Use case: A CIS uses a data transformation service to convert data represented using one information model (e.g., CCD) into data represented using a different information model required by a DSS (e.g., vMR). Relevant standards: Various information model and terminology standards (see “Use of Appropriate, Standard Information Models and Terminologies” above).
Ability to Leverage a Data Presentation Service Source: HL7 CDS Work Group, literature⁴	Description: The CIS is able to use a service to render structured data into a human-readable format. Use case: The disease management module of an EHR system uses a data presentation service to convert an XML document representing diabetes care needs into an HTML diabetes management dashboard to be presented to a clinician. Relevant standards: W3C XSL Formatting Objects (http://www.w3.org/wiki/Xsl-fo).
Ability to Populate a Data Warehouse in Real-Time Source: HL7 CDS Work Group	Description: The CIS is able to populate an enterprise data warehouse in real-time, as opposed to nightly batches. Use case: A healthcare organization builds CDS functionality against the data warehouse. Relevant standards: None identified.
Maintenance of Audit Logs Source: HL7 CDS Work Group	Description: The CIS maintains an audit log of all service interactions. Use case: A CIS maintains an audit log of data provided to, and recommendations received from, an external CDS service. Relevant standards: Healthcare Information Technology Standards Panel (HITSP) SC109.