Trisotech the Ingenious

Trisotech Healthcare Feature Set (HFS)

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Business Rules and Decision Management in Healthcare

The Healthcare Feature Set (HFS)

In support of the BPM+ Health Community of Practice, Trisotech is enhancing its Digital Enterprise Suite (DES) with healthcare-specific extensions. The Healthcare Feature Set (HFS) offers new features and functions that allow healthcare organizations to model and automate their decisions and workflows.

Access is provided to FHIR®, CDS Hooks™, and SMART™ on FHIR, as well as AI and Machine Learning (ML) capabilities. In addition, a learning package on how to automate Clinical Practice Guidelines (CPG) using BPM+ best practices is available. The Healthcare Feature set makes understanding and using the latest interoperability standards in healthcare technology available in a modern, easy-to-use way that is compatible with existing software systems in any healthcare setting.

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Attended Tasks

The Trisotech Attended Task feature allows for validation and confirmation of the inputs and/or outputs of any automated task by the care provider user. This feature ensures that a knowledgeable human expert can correct/modify just-in-time the information.

HFS Knowledge Features

The Healthcare Feature Set provides common healthcare observation and condition Concepts that can be re-used for healthcare models. These concepts can be dragged-and-dropped into decision models (DMN), workflow models (BPMN), and case model (CMMN). The concepts can also be linked to any terms in the labels of various model elements. Users can modify the pre-configured entries and create additional entries.

Most Common Observations

This Knowledge Entity Model contains a set of common Healthcare Observation Concepts. Each provided term comes with a definition and disambiguation using appropriate LOINC codes, SNOMED CT codes, and FHIR resource types. Topics covered include:

  • Body Measures and Vital Signs
  • Chemistry Tests
  • Hematology Tests
  • Cardiac Measures
  • Kidney Measures and Urinalysis
  • Respiratory Measures
  • Surgical Measures
  • Healthcare Measures
  • Ob Gyn Measures
  • Pathology Measures
  • Neurologic Measures
  • Hepatopancreatobiliary Measures
  • Miscellaneous Observations

Most Common Conditions

This Knowledge Entity Model contains a set of common Healthcare Condition Concepts. Each provided term comes with a definition and disambiguation using pre-configured ICD10 codes and FHIR resource types. Topics covered include:

  • Oncology
  • Cardiovascular Disease
  • Hematology Disorders
  • Genitourinary Disorders
  • Endocrine and Metabolic Disorders
  • GI and Hepatobiliary Disorders
  • Respiratory Disorders
  • Neuropsychiatric Disorders
  • Nutritional Disorders
  • Immune and Rheumatologic Disorders
  • Musculoskeletal Disorders
  • Dermatologic Disorders
  • Obstetrics and Gynecology Disorders
  • Infectious Diseases
  • Temperature Regulatory Disorders

HFS Terminology Features

The Healthcare Feature Set allows concepts used in Workflow, Decision and Case models to be healthcare coded using healthcare coding systems (SNOMED CT, LOINC, RxNorm, ICD, etc.) and ValueSets.

Connection to a FHIR Terminology Server

As part of the Healthcare Feature Set, it is possible for the administrator of a Trisotech software instance to configure a connection to a terminology server of choice that adheres to the FHIR Terminology Sever specification. When established, this FHIR terminology server connection allows searching for codes and Value Sets without having to become experts in the details of healthcare coding systems. It also reduces variability in the healthcare codes used.

Coding and ValueSet assignment

The Healthcare Feature Set adds a Healthcare Tab in the Knowledge Entity Modeler (KEM). This feature allows concepts defined in a knowledge model to be healthcare coded. Manual and autofill lookups (with a terminology server connection) assignment of codes and Value Sets are possible in the Healthcare tab.

HFS FHIR Features

Trisotech’s Healthcare Feature Set allows for data storage, retrieval, and patient data exchange using the FHIR (HL-7®) interoperability standard. Re-useable FHIR data types and drag and drop FHIR resources are available for over 145 predefined FHIR Resource structures.

The categories of supported FHIR Resource structures include:

  • Conformance
  • Terminology
  • Security
  • Documents
  • Other
  • Individuals
  • Entities
  • Workflow
  • Management
  • Summary
  • Diagnostics
  • Medications
  • Care Provision
  • Request & Response
  • Support
  • Billing
  • Payment
  • General
  • Public Health & Research
  • Definitional Artifacts
  • Evidence-Based Medicine
  • Quality Reporting & Testing
  • Medication Definition

Predefined FHIR Data types

Trisotech provides out-of-the box FHIR data types that can be assigned with one click to elements in Decision models (DMN), Workflow models (BPMN), and Case models (CMMN).

The FHIR Accelerator

The FHIR Accelerator is a comprehensive set of predefined FHIR Resource structures provided as reusable drag and drop data structures. Simply drag the desired FHIR resource to a Decision (DMN), Workflow (BPMN) or Case (CMMN) modeling canvas to obtain an element of that type.

HFS CDS Hooks Features

CDS Hooks is one of the most common ways to embed Clinical Decision Support (CDS) automation functionality in a clinician’s workflow. When an EHR system notifies external services that a specific activity occurred within an EHR user session, a CDS service can gather needed data elements through FHIR services and return information to the clinician in the form of a “card.”

Trisotech’s decision modeling and automation, in conjunction with CDS Hooks support, delivers real-time clinical decision support during patient encounters allowing providers to consider alternative diagnoses, treatments, and potential cost-saving measures for their patients.

CDS Hooks Server

As part of the Healthcare Feature Set, Trisotech provides a CDS Hooks server to accept decision support requests and generate CDS Cards in return. CDS Services may require specific FHIR Resources to compute the decisions the CDS Client requests. These FHIR Resources are obtained by passing “prefetched” FHIR data from the FHIR Server to the CDS Service via a service call to the supplied CDS Hooks endpoint.

CDS Card Accelerator

Trisotech provides a predefined reusable drag and drop data structure for CDS cards via the CDS Card Accelerator making them easy to define and populate in decision models, workflows and cases.

CDS Card Data types

Predefined CDS Card data types can be assigned with one click to elements in Decision models (DMN), Workflow models (BPMN), and Case models (CMMN). Trisotech supports information cards that provide text for the clinician to read, suggestion cards that provide a specific suggestion with a button that the user can click to accept and automatically populate the suggested change into the clinician’s UI, and app link cards that provide a link to an app (typically a SMART app) where the user can supply details, step through a flowchart, or do anything else required to help reach an informed decision.

Customizable CDS Hooks Cards

The Trisotech CDS Card data structures are customizable and include constrained field dropdowns where appropriate to assure easy conformance. For example, Info, Warning, or Critical indicators for information cards. Data in CDS Cards is populated via logic in a decision, workflow, or case models.

HFS SMART Application Features

Autogenerated SMART on FHIR webapps

With the Healthcare Feature Set, Smart on FHIR web applications can be created from decision, workflow and case models using one-click deployment. Links to those SMART of FHIR applications are automatically generated and are suitable for inclusion on app link CDS Card types or any SMART compatible environments.

HFS Additional FEEL Functions Features

Healthcare Coding Functions

Healthcare-specific built-in FEEL functions are available in the Digital Modeling Suite to access defined Concepts and related healthcare codings (e.g. ICD-10, LOINC, etc.) at run time in the Digital Automation Suite. Examples of such functions are:

  • function that returns all healthcare codes for given Concept
  • function that returns a collection of all Concept names available in the model
  • function that returns TRUE if one or more supplied codes is defined in one or more supplied Concepts

FHIR Accessor Functions

Healthcare-specific built-in FEEL functions that simplifies accessing FHIR data for a more abstract Healthcare Concepts. For example, the concept of “last observation on A1c” would be translated into the actual specific FHIR query(ies) required to retrieve the correct data from the FHIR server.

HFS Learning Features

A Learning Package – Automating a Clinical Practice Guideline (CPG): BPM+ Best Practices

The goal of this learning package is to describe the sequence of steps required to convert the evidence-based knowledge encapsulated in a clinical practice guideline (CPG) to deployable clinical artifacts using BPM+ Health modeling standards. Each step will present both technical requirements and best practices.

1 introduction to BPM+ Health
2 introduction to methodology
3 narrative elicitation
4 concept model of the narrative
5 computational independent model (CIM)
6 shared data model
7 platform independent model (PIM)
8 platform specific model (PSM)

Healthcare Feature Set

Healthcare Feature Set is an option of the Digital Enterprise Suite

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HL7®, and FHIR® are the registered trademarks of Health Level Seven International and the use of these trademarks does not constitute an endorsement by HL7.

CDS Hooks™, the CDS Hooks logos, SMART™ and the SMART logos are trademarks of The Children’s Medical Center Corporation.


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