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Immunization Calculation Engine (ICE)

Immunization Calculation Engine (ICE). An Open-Source, Configurable Clinical Decision Support System that Integrates with Any Clinical Information System through a Standards-Based Web Service Interface – Utilized for Immunizations. Public Health Informatics Conference 2014.

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Immunization Calculation Engine (ICE)

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  1. Immunization Calculation Engine (ICE) An Open-Source, Configurable Clinical Decision Support System that Integrates with Any Clinical Information System through a Standards-Based Web Service Interface – Utilized for Immunizations Public Health Informatics Conference 2014 Michael Suralik, HLN Consulting, LLC Regina Austin, HLN Consulting, LLC April 29, 2014

  2. Agenda • Clinical Decision Support Services • The ICE Software System • Integrating ICE with Clinical Information Systems

  3. Benefits of CDS • Improved quality of care • Better health outcomes • Avoidance of errors and adverse of events • Improved efficiency • Reduced costs • Increased provider/patient satisfaction

  4. CDS is Not Widely Available • CDS is complex • CDS capabilities have been tightly coupled with specific institutions and health IT systems • Re-using CDS implemented elsewhere is difficult

  5. The Need Application-independent CDS resources that can be efficiently leveraged by diverse healthcare systems and health IT settings to improve patient health

  6. OpenCDS www.opencds.org • Collaborative project, led by Dr. Kensaku Kawamoto at the University of Utah • A software platform and toolkit for developers implementing CDS services • Open source 6

  7. ICE Project

  8. Collaboration of public health agencies, academic researchers, and a private firm Leveraged OpenCDS to implement CDS for immunizations (aka “immunization forecasting”) Needed by providers and public health agencies The ICE Project

  9. ICE Software System • ICE Web Service • Provides immunization forecasting to clinical systems through a web service interface • Supports routinely administered vaccine groups, from infant to adult • CDS Administration Tool (CAT) • Web-based tool enables non-technical subject matter experts (SMEs) to manage ICE • Human readable rules

  10. ICE Web Service Inputs: DOB, gender, immunization history, disease immunity Immunization schedule identifier, date of evaluation Outputs: Validity of immunization history + reasons Immunization recommendations + reasons 10

  11. Sample ICE Deployment 11

  12. Software Architecture • ICE/OpenCDS • Tomcat or JBoss AS (aka “WildFly”) • JBoss Drools (rule engine/database) • JBossjBPM (process/workflow) • HL7 vMR (data model) • CAT • JavaServer Faces (GUI) • Enterprise JavaBeans (business logic) • Apache Derby JVM (database)

  13. Ease of Adoption and Integration with Clinical Information Systems

  14. Open-Source • ICE built with only open-source software • No dependencies on any commercial software • Released under a standard open-source license • GNU Lesser General Public License version 3 (LGPL v3) • Any system (even proprietary systems) may use/modify/integrate with ICE at no cost • Any modifications to ICE software must be shared • No warranty

  15. Flexible Deployment Options Java-based system runs on variety of hardware/operating system platforms Deploys on same or different server as the client system 15

  16. Standards-Based Interface

  17. ICE Wiki www.cdsframework.org

  18. Technical Documentation ofICE’s Standards-Based Interface

  19. Production Use of ICEby an EHR System • eClinicalWorks (eCW) v10 uses ICE to deliver evaluations and recommendations • Integrated by eCW developers, with minimal support from ICE team • No modifications to the default configuration • ICE is hosted by eCW at central location

  20. Summary of the ICE Software System • Freely available • Standards-based • Easily integrates with other systems • Maintainable by non-developers • Collaboratively developed • Transparent • Can be leveraged for other types of CDS

  21. Leverage Our Work for Other Types of CDS • Drug interaction/allergy (warning) • Abnormal lab result (alert) • Ordering of appropriate lab test (critique) • Disease management (reminder) • Treatment/care plans (recommendation) • Automated redaction of sensitive data from clinical documents

  22. Clinical Decision Support Administration Tool(CAT)

  23. Clinical Decision Support Administration Tool (CAT) • Graphical user interface • Non-technical SMEs may configure ICE • Create, edit, delete… • Vocabulary and code sets • Schedule parameters • Rules • Test cases • Can expand to other clinical domains

  24. Code System Editor 24

  25. Vaccine Editor 25

  26. Vaccine Series Editor

  27. Rule Editor - Example: Varicella Rule for Patients Born before 01/01/1980

  28. Test Editor (Test Case View)

  29. Test Editor (Test Results View)

  30. Mike Suralik 856-751-1094 suralik@hln.com OR URL: www.hln.com/ice Email: ice@hln.com For More Information about ICE…

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