The Morningside Initiative: Sharing of Knowledge and Methods for Clinical Decision Support

1. The Morningside Initiative:Sharing of Knowledge and Methods for Clinical Decision Support American Medical Informatics Association; Arizona State University; Department of Defense Tri-Care Management Activity, Military Health System; Henry Ford Health System; Intermountain Healthcare; Kaiser Permanente; Partners Healthcare; Veterans Healthcare Administration External Knowledge Sources Shared Knowledge Base Goals and approaches • Overcome resistance to sharing clinical decision support (CDS) knowledge, methods, and experience among organizations • Establish feasibility with small group of committed and experienced participants • Develop an organizational framework for collaboration • Intent to become self-sustaining • Establish functional requirements for content and tools to foster interoperability • Address knowledge acquisition, representation/ markup, curation, and localization • Drive process with use cases requiring SOA-based implementation • Develop representations and tools to overcome technical barriers • Adopt standards and drive development of ones that are lacking to foster interoperability • Identify and separate medical vs. business logic and facilitate localization and adaptation • Content foci • Begin with implemented CDS knowledge content and reuse • Initially diabetes rules and order sets • Subsequent goal of assimilating best practice knowledge Sponsorship • Convening and organizational support by TATRC • AMIA to provide organizational home for public-private partnership during early stages Structure • Steering Committee • Representatives of each organization • Processes and procedures for collaboration, pursuit of funding, growth of initiative, approach to long-term sustainability • Content Committee • Use-case driven focus on kinds of application needs, sources of knowledge, editing and approval process, application of knowledge • Technical Committee • Tools and resources to share, manage, represent, update knowledge Functional requirements • Driving use cases: Interoperable delivery of CDS at point of care through SOA interface • DoD AHLTA and NHIN interoperability node as first case • Goal of establishing a Knowledge Management Repository (KMR) and Guideline Workbench • To deliver CDS into AHLTA environment via SOA • Show interoperability on the NHIN DoD Federal Adapter • Overall model has 4 components • Knowledge Repository – the content • Maintaining stages of analysis, provenance of content • Target of standard representation with annotations enabling localization and adaptation to particular settings • Tools for knowledge acquisition, markup, management, and localization - the technology • Methods, ontologies, and schemas for sharability • Meta data tags, standards, templates, and vocabularies for representation and markup • Taxonomy of process/workflow/implementation contexts • SOA-based delivery – the execution environment • Not the focus of Morningside but provide the driving use cases Collaborative Knowledge Management Enterprise Knowledge Base Enterprise Knowledge Base Enterprise Knowledge Base Guidelines Reminders Alerts Order sets …