Interoperability through FHIR
Fast Healthcare Interoperability Resources (FHIR) is a next-generation standards
framework from the HL7 organization. It supports the interoperability and exchange of
healthcare-related
information,
including clinical, administrative, public health, and research data between
organizations. Pega Care Management uses the HL7 FHIR resources to enable
interoperability through a common data structure. The Pega Care Management
application leverages FHIR APIs from the Healthcare Foundation to
receive and transmit electronic health data and populate the eligible sections in the
Patient 360. By installing
Pega Foundation for Healthcare and using its
pre
Pega Foundation for Healthcare provides an option to
conditionally call a source of data: either the FHIR repository or an alternative source
of data (for
example,
an internal source of data). This option allows you to easily configure various sources
of data based on your business needs. It means that you do not need to build additional
data pages to connect to a separate source of data. The following table lists the out-of-the-box data pages that are related to member,
clinical, and care information: D_PatientSearchResults D_Member D_GetNonClaimMedicalHistory D_FamilyMedicalHistoryByMemberID The data sources for all configured resources are fetched through the
D_CheckDataSource dynamic settings data page. The following figure shows the D_CheckDataSource data page: The CheckDataSource data transform is configured to fetch the data
source. This rule is configured with PEGA DB as a default source as shown in the
following figure. Use the extension rule to update your application with the data
source of your choice for each resource. When the FHIR API is used to fetch information, the Encounters
section on the Administrative tab for a
Pega Care Management care plan includes the patient encounter
details. The Family Medical history section on the Health
History tab includes the family history. If you use the common object model,
both family and patient history are displayed in the Family medical
history on the Health History tab. The following figure shows that the Encounters section includes
only the patient history when you use the FHIR API: The following figure shows that both the family and patient history are included in the
Family medical history section when you use the common object
model. The ability to create care plans with data from external sources is supported for
healthcare organizations that manage their patient populations through programs in Pega Care Management. Use existing FHIR APIs to configure GET and PUT
methodologies to fetch and display care plans. The
methodologies
also
support the transmission of certain care plan elements from the
Pega Care Management application to external electronic medical
records to improve patient safety and clinical efficacy. As part of the enrollment, the system generates a care plan and can include tasks and
goals. However, adding care plan elements and edit options are not supported for care
plans that the system generates from EMR. When the care plan uses the FHIR API, a care
manager can update the tasks that originate from the EMR, and a PUT API call updates the
EMR. Pega Care Management appends EMR-based care plans with the EMR logo to
differentiate from care plans that users create by using the
Pega Care Management application. The job scheduler runs daily to fetch the care plans from external systems (EMR) and
display them in the
Pega Care Management application. Organizations can update the
frequency of the job scheduler based on their business requirements. By default, the
job scheduler is disabled, and you need to enable it so that the job scheduler can get
the care plans from EMR. For information on enabling the job scheduler, see Enabling the job scheduler to get care plans from the EMR. The following figure shows that a patient is enrolled in a Respiratory therapy program
from an EMR: Implementation
teams need to enable the job scheduler to get the care plans from the EMR
system. You might need to map from your EMR to the care plan by using the
MapCustomerIDforCarePlanExtn data transform so that the patient
information is updated in the care plan. Pega Care Management uses queue processing to create care plans and post
updates to EMR/EHR systems. By searching for the CreateCarePlanCaseFromFHIR queue processor,
you can view the settings as shown in the following figure: Pega Care Management creates queue items when a goal or task is updated on the
Care tab. By using the
PostCareplanUpdates queue processor, you can see the
settings, as shown in the following figure: By default, the queue item processing is delayed by 30 minutes to ensure a single API
call in case of multiple updates. Based on your organization's requirement, you can
configure this time delay. Multi-source configuration in data pages
Data pages
Object type Data page Member Allergies D_GetAllergies Conditions D_GetClinicalConditionByMember Encounters D_MemberEncounterDetails Medications D_PatientMedications Observations D_ObservationsByLoincNum Family Medical History Dynamic settings to configure the data source
Display of family and patient history
Care plan API
Enabling the job scheduler to get care plans from the EMR
Optional: Mapping from external systems to the care plan
Use of queue processing in care plan creation and updates
Care plan creation
Updates to the care plan
Optional: Setting delay time for queue entry
Previous topic Modifying rules to support General Data Protection Regulation Next topic Personas, access groups, and access roles