Section 3: Clinical and Administrative Domains
Section 5: Implementation Guides
HL7 Version 3 Implementation Guide: Context-Aware Knowledge Retrieval Application (Infobutton), Release 4
The Context-Aware Knowledge Retrieval (Infobutton) specifications provide a standard mechanism for clinical information systems to request context-specific clinical knowledge form online resources. This has become a widely adopted approach to help clinicians and patients answer their clinical questions that arise in the course of care. These kinds of knowledge retrieval tools have been generally known as "Infobuttons." Based on the clinical context, which includes characteristics of the patient, provider, care setting, and clinical task, infobuttons anticipate clinicians’ and patients’ questions and provide automated inks to resources that may answer those questions. For example, an infobutton displayed in the context of a patient’s problem list may allow a clinician to retrieve treatment guidelines on a specific condition as well ass to retrieve relevant patient education material to share with the patient.
The Infobutton URL-based Implementation Guide provides a standard mechanism for EHR systems to submit knowledge requests to knowledge resources over the HTTP protocol through a standard using a URL format. Compliance with this specifications is required for EHR certification in the US EHR Meaningful Use Program.
HL7 Version 3 Implementation Guide: Context-Aware Knowledge Retrieval Application (Infobutton), Release 4 may also go by the following names or acronyms:
- Clinical Information System Developers
- Clinical Knowledge Resource Publishers
- Clinical Decision Support Developers
- Healthcare Organizations
- Clinical and Public Health Laboratories
- Immunization Registries
- Quality Reporting Agencies
- Standards Development Organizations (SDOs)
- Pharmaceutical Vendors
- EHR, PHR Vendors
- Health Care IT Vendors
- Clinical Decision Support Systems Vendors
- Lab Vendors
- Emergency Services Providers
- Local and State Departments of Health
- Medical Imaging Service Providers
- Healthcare Institutions (hospitals, long term care, home care, mental health)
- Enables the retrieval of contextually relevant, patient-specific knowledge resources from within clinical information systems, helping providers and patients answer their clinical questions raised in the course of care
- Supports patient-centered care by enabling patients to be partners in the decision-making process
- Promotes evidence-based practices through EHR technology to improve health care quality
- Required for EHR certification in the US Meaningful Use Program
- OpenInfobutton project - http://www.openinfobutton.org/
- Columbia University LITE (Librarian Infobutton Tailoring Environment) at https://lite.dbmi.columbia.edu/
- Other projects and references at http://www.openinfobutton.org/site/infobuttonsforcprs/infobutton-knowledge-base
Clinicians and patients often raise clinical questions in the course of patient care. Research shows that over half of these questions go unanswered and that these unanswered questions have a negative impact on patient care. Online health knowledge resources are widely available. Research has shown that these resources are able to answer most of clinicians’ and patients’ clinical questions. Yet, important barriers hinder a more effective and frequent use of these resources to support decision-making.
An effective solution to lowering those barriers is to integrate knowledge resource access into the patient care workflow through EHR systems. The Context-Aware Knowledge Retrieval (Infobutton) Standard provides a set of specifications that enable this kind if integration in a standard fashion. An 'infobutton' is a point-of-care information retrieval application that automatically generates and sends knowledge requests to on-line health knowledge resources based on a particular CIS context.
This specification focuses on a context-aware knowledge retrieval transaction, primarily on the knowledge request step, representing a context-aware knowledge request event initiated by the EHR (e.g., as a result of a user clicking on an Infobutton).
Currently, e-resources typically provide HTTP-based application program interfaces (API) that can be used by infobuttons. However, these APIs are based on proprietary syntax and vocabularies, requiring the development of custom software for each e-resource that an infobutton needs to link to.