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Immunization Calculation Engine (ICE) An Open-Source, Configurable Clinical Decision Support System that Integrates with Any Clinical Information System.

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Presentation on theme: "Immunization Calculation Engine (ICE) An Open-Source, Configurable Clinical Decision Support System that Integrates with Any Clinical Information System."— Presentation transcript:

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

3 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 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 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 6 Collaborative project, led by Dr. Kensaku Kawamoto at the University of Utah A software platform and toolkit for developers implementing CDS services Open source

7 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 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

11 Sample ICE Deployment 11

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

13 13 Ease of Adoption and Integration with Clinical Information Systems

14 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 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

16 16 Standards-Based Interface Attribute of ICE Conforms to Relevant Technical Standard Messaging framework Simple Object Access Protocol (SOAP) Web Service interface Decision Support Service (DSS) – an HL7 & OMG standard – Data modelVirtual Medical Record (vMR) – an HL7 standard – Virtual_Medical_Record_(vMR)

17 17 ICE Wiki

18 18 Technical Documentation of ICE’s Standards-Based Interface

19 19 Production Use of ICE by 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 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 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 22 Clinical Decision Support Administration Tool (CAT)

23 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 24 Code System Editor

25 25 Vaccine Editor

26 26 Vaccine Series Editor

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

28 28 Test Editor (Test Case View)

29 29 Test Editor (Test Results View)

30 30 For More Information about ICE… Mike Suralik OR URL:


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