Governance!! The real key to digital health interoperability!

Hey Lloyd... it looks like the discussion is happening on the other thread:
infocentral.infoway-inforoute.ca/en/forum/266-fhir-implementations/2995-canadian-fhir-baseline-profiles-governance-stream-meeting-september-27th-2-3pm-est#5351 :-)

Hi Derek,

The CA Core profiles should, ideally, be defined as independently of context as possible. The intention is that they should form a common 'base' that systems can count on independent of most contexts. Obviously there'll need to be some:
- human patients
- identified patients (i.e. not anonymized research/secondary use)

And these will be used for workflows defined outside of IHE as well (e.g. SMART on FHIR, CDS Hooks, etc.)

I'm fully supportive of IHE evaluating the profiles and considering how they might fit within IHE's current specifications, but we should avoid trying to tighten them overly much to reflect any particular use-case or set of use-cases. And we also shouldn't presume that IHE would be the only definer of the contexts in which the profiles would be used. (I recognize that your words might not have been intended to appear that way, but just wanted to clarify.)

Hi all -- and sorry to be sparse these last few weeks in providing updates to the IHE community.

I want to give a shout-out to Michael Savage and the very-engaged folks on the FHIR Implementer's community Governance thread. Today's call was really insightful and some very useful ideas surfaced. For those that want to follow the discussion, Michael will be posting notes on the FHIR Implementer's forum .

In my view -- one of the important takeaways from the call was that our work in developing Canadian core FHIR baseline profiles needs to be framed in the context of use cases (props to Francis for articulating this so clearly on today's call). Sadly, here is where we pay a small penalty for over-loading terms. What we need are for our FHIR profiles to be framed within the context of IHE Profiles (more analogous to FHIR IG's). We need these IHE Profiles to articulate how the FHIR technical artefacts are to be employed to support healthcare workflows and, importantly, how we can conformance-test digital health solutions to ensure they are faithfully operationalizing the normative specs. Conformance-testability, in my experience, represents a crucial difference between FHIR IG's and IHE Profiles.

So... as luck would have it... this month and next month represent an "intake" opportunity to submit new work item proposals to IHE's Patient Care Coordination ( PCC ), IT Infrastructure ( ITI ) and Quality, Research and Public Health ( QRPH ) technical committees. In my view (and thank you, Russ, for suggesting this) it would be very smart for us to frame some of our ongoing FHIR profile work within the context of a conformance-testable healthcare workflow spec (i.e. an IHE Profile).

Such capital-P Profiling work would afford us a way to collaboratively engage with our clinical partners and our jurisdictional partners and our vendor partners. As was identified on today's FHIR community call... a consensus-building effort like this lays the groundwork for establishing the GOVERNANCE we are going to need in order to get broad adoption of our Canadian core FHIR baseline specifications.

On today's call, Francis suggested medication management as a good first-candidate. What do others think about this idea?? Please, let's use this thread to brainstorm and discuss. I'd also be happy to host a call if folks would like to brainstorm in real time!