This application registers hematopoietic cell transplant (HCT) or cellular-therapy (CT) patients to the Center for International Blood and Marrow Transplant Research® (CIBMTR) for outcomes research, and displays acute Graft versus Host Disease (GVHD) data found in the EHR.
This is an early version of the application and is limited to transplant center partners who have agreed to provide feedback. Later versions will include reporting GVHD to CIBMTR and other Observations.
CIBMTR is a research collaboration between the National Marrow Donor Program® (NMDP)/Be The Match and the Medical College of Wisconsin. The CIBMTR has made an immense impact in HCT and CT research, building on its unique resource of high-quality patient level data. To further this, there has been significant effort and progress towards increasing the data quality and quantity, and decreasing the burden of manual data input. This has improved the level of detailed data available for state of the art analysis within observational, clinical trials. This app is a proof-of-concept in this direction, enabling data managers and physicians to report patient data directly from the EHR to CIBMTR. In this first iteration, the CIBMTR Reporting app currently registers a HCT and/or CT patient to the CIBMTR for outcomes research.
The app will match a selected patient from the EHR to CIBMTR's own patient records. If none are found, a new CIBMTR Research ID (CRID) is created and assigned to the patient, and the CRID is displayed in the app. This app also displays acute GVHD data and is an initial step to reduce manual data entry through web-based forms. The first iteration of this application is being distributed through Epic AppOrchard to interact with Epic systems used by HCT and CT centers.
The CIBMTR Reporting app is launched from Epic Hyperspace with a selected patient from the EHR. The user must provide valid CIMBTR FormsNet username and password to connect to CIBMTR/NMDP.
The app displays the patient data and any GVHD observations found in the Epic GVHD flowsheet for the selected patient upon successful login.
On launch, if the patient data already exists in CIBMTR, the app displays the existing CRID and “register” button is disabled. If the patient data doesn’t exist in the CIBMTR FHIR server, the “register” button is enabled.
When the user clicks on the “register” button, the patient is registered in CIBMTR and the app displays the CRID in the app user interface. The patient resource with assigned CRID are stored in the CIBMTR FHIR server, and loaded into FormsNet.
This application will also display acute GVHD data that have been entered into Epic GVHD flowsheets. A later version will allow the user to report selected GVHD data to CIBMTR (the “Submit to CIBMTR” button is disabled in the initial version).
The first iteration of this application is being distributed through Epic AppOrchard to interact with Epic systems used by HCT and CT centers.
The CIBMTR Reporting app uses HL7® FHIR® to securely transmit transplant outcomes data to CIBMTR. The app uses SMART-on-FHIR specification via OAuth2 to connect to the Epic FHIR API. Secure authentication to CIBMTR is provided using existing CIBMTR FormsNet OKTA logins managed by NMDP. All REST services to CIBMTR/NMDP are managed using a WSO2 API. Authorization based on existing FormsNet user roles is maintained internally in the client backend. This app is configured to access the Epic and CIBMTR FHIR server endpoints and serves as a process for submitting outcomes data to CIBMTR. After successful login, the app displays the selected patient data.
On Client launch, an authentication request is made to an OKTA identity provider for CIBMTR/NMDP login and selected Observation resources for this Patient are retrieved from the Epic FHIR server. The Client performs a search for a matching previously-registered Patient resource in the CIBMTR FHIR server and any existing CRID is returned, if no existing CRID is found, the “Register” button is enabled. The “Register” button initiates a call to the “Client Backend” via a WSO2 API gateway which returns a new or matched CRID from the FormsNet database. The CIBMTR FHIR server and FormsNet database are then updated with the Patient resource information and new CRID.
