Did you have a chance to attend our recent webinar, “Digital Data Stewardship™ for Trusted, High-Quality Data Exchange”?
We received more questions than we had time to answer in the allotted time, so our presenter, Carol Graham, Product Manager for Pivot™ and Nomentys™ offerings at Clinical Architecture, answered them below in this Q&A-style blog post.
Q: Can Pivot be plugged in to EMR/EHRs?
A: Pivot can be integrated into EHRs via its suite of RESTful APIs, but depending on the use case needed by the EHR, Pivot or another Clinical Architecture solution such as Symedical might be most useful.
Q: How is Pivot different from an interface engine?
A: Pivot is more of a plug-in to an interface engine rather than a replacement for an interface engine. Pivot can make it easier, faster, and less resource-intensive to stand up data feeds, and Pivot’s data quality uplift can also make the output of an interface engine more usable across an organization’s data feeds. Typical interface engines will have message movement/acknowledgement features and connectivity features that Pivot does not have.
Q: Do you support all HL7v2 versions and the standard triggers that come along with them?
A: Pivot’s HL7v2 ingest is designed to accept a broad selection of versions and message types/triggers. Message types/trigger events are driven by customer use case and typically cover reporting of clinical or encounter data rather than scheduling, inventory, workflow, etc. Pivot’s typical V2 output is HL7v2.7, but other formats are available on request.
Q: How do you address updates to terminology mappings with regard to data that has previously been mapped?
A: This is a two-part answer: Part 1 addresses updates to existing mappings when the underlying terminology (map target vocabulary) is updated, and Part 2 addresses real-time updates to user maps as new data flows into Pivot.
Part 1: Terminologies are updated by the authoring organization (e.g., terms are retired or added)
Pivot’s mapping capability is powered by Symedical, Clinical Architecture’s flagship terminology management platform. Symedical has comprehensive change management capability that allows the user to receive automated notifications when terminologies are updated, have a system-wide view into how those terminology changes affect existing maps and other content assets, and to proactively manage when, where, and how those updates are applied. Symedical also maintains a comprehensive change history so that all changes to terms and mappings are tracked over time and are fully accessible to the user.
Part 2: Real-time updates to maps as new data flows into Pivot
Pivot’s mapping engine continuously updates maps as new patient messages flow through. If a message contains a new term that is previously unmapped, Pivot adds that term into Symedical, and Symedical attempts to automatically map to the best match in the target vocabulary. Pivot can be configured to either wait for all terms to be mapped before delivering a message downstream, or it can deliver the message without waiting for new terms to be mapped.
Q: Does a Pivot license include Symedical or is that a separate purchase?
A: Pivot licensing may include Symedical if the customer’s use case includes terminology normalization, rules-based analysis (“inferencing”), or other value-add capabilities of Symedical.
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