SMART ANC DAK Feedback

Goal

Outline quarterly findings to share with the WHO SMART working group



Findings in Q3 2022: July-Sept

#

Type

Notes

Source/Contact

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Type

Notes

Source/Contact

1

Clinical Content

Not meeting minimum expectations (PIH) eg clear fetal outcome

PIH



Codes

Why not mapped to CIEL?! (Are we just missing a spreadsheet that already has these mappings?)

AK: Reportedly WHO does not recognize CIEL as a terminology for the published DAK. I have a spreadsheet that includes CIEL mappings, however. It is not 100% complete, so there still is work depending on the scope of coverage.

Implementer: Wish that CIEL was part of the FHIR IG term mappings. Would make it a lot easier. https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/branches/master/Condition-anc-b10-de73-example.json.html





FHIR IG

 FHIR IG confusing w/ ++ broken links. Video walkthrough would be ++ helpful for new teams. 





FHIR IG

FHIR IG needs to be clearer about the fact that Bryn’s team has created an opensource Decision Support Engine (now maintaining this, Google Android SDK group is their user at the moment). DAK processor is different from this engine. Very far upstream. No run-time components. And, your system doesn’t actually need careplan support to make use of the engine. What really matters is the FHIR representation of the medical record. (We were panicked by the huge lift required to support careplans in a backend that was created long before FHIR plandefinitions - turns out that was an unnecessary worry)







For the DAK to require use of WHO internal IDs for data variables, this breaks the standardization model. These spreadsheet codes should be replaced by SAME-AS reference concepts that will be standard maps from existing data sources. Requiring data elements to be mapped to a spreadsheet/tab/cell ID is not sustainable and produces duplicate concepts.

Akanter



Multiple Concept IDs for same thing!

Did they mean "Visually Disturbed"? As in, woman seems upset? Is this "visual disturbance" different than the other Visual disturbance?















→ Needed: List of reasons this Engine should be a funding priority for SMART Guideline implementation success. (We think it should be - we need to be clear why)