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. 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, literature11,13,14,17,18,24,26,31,3438,4042
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.