Making Science Computable Using Evidence-Based Medicine on Fast Healthcare Interoperability Resources: Standards Development Project

BackgroundEvidence-based medicine (EBM) has the potential to improve health outcomes, but EBM has not been widely integrated into the systems used for research or clinical decision-making. There has not been a scalable and reusable computer-readable standard for distributing research results and synthesized evidence among creators, implementers, and the ultimate users of that evidence. Evidence that is more rapidly updated, synthesized, disseminated, and implemented would improve both the delivery of EBM and evidence-based health care policy. ObjectiveThis study aimed to introduce the EBM on Fast Healthcare Interoperability Resources (FHIR) project (EBMonFHIR), which is extending the methods and infrastructure of Health Level Seven (HL7) FHIR to provide an interoperability standard for the electronic exchange of health-related scientific knowledge. MethodsAs an ongoing process, the project creates and refines FHIR resources to represent evidence from clinical studies and syntheses of those studies and develops tools to assist with the creation and visualization of FHIR resources. ResultsThe EBMonFHIR project created FHIR resources (ie, ArtifactAssessment, Citation, Evidence, EvidenceReport, and EvidenceVariable) for representing evidence. The COVID-19 Knowledge Accelerator (COKA) project, now Health Evidence Knowledge Accelerator (HEvKA), took this work further and created FHIR resources that express EvidenceReport, Citation, and ArtifactAssessment concepts. The group is (1) continually refining FHIR resources to support the representation of EBM; (2) developing controlled terminology related to EBM (ie, study design, statistic type, statistical model, and risk of bias); and (3) developing tools to facilitate the visualization and data entry of EBM information into FHIR resources, including human-readable interfaces and JSON viewers. ConclusionsEBMonFHIR resources in conjunction with other FHIR resources can support relaying EBM components in a manner that is interoperable and consumable by downstream tools and health information technology systems to support the users of evidence

Orienting the work-based curriculum towards work process knowledge: a rationale and a German case study

First paragraph: The term 'work process knowledge' refers to the knowledge needed for working in flexible and innovative business environments, including those in which information and communication technologies have been introduced to integrate previously separated production functions. It involves a systems-level understanding of the work process in the organization as a whole, enabling employees to understand how their own actions interconnect with actions being taken elsewhere in the system. Work process knowledge is 'active' knowledge that is used directly in the performance of work, and is typically constructed by employees when they are solving problems in the workplace. It is more than simple know-how because constructing it involves synthesizing knowhow with theoretical understanding. The paper outlines principles for constructing a work-based curriculum when work process knowledge is a desired outcome. These are illustrated by a case study of a vocational curriculum currently being adopted by a leading volume car manufacturer in Germany. The key features of this approach areÐusing a model of the work process as the curriculum framework, co-producing (and co-delivering) the curriculum using integrated teams of staff from the vocational school and the workplace, and fusing the different knowledge resources of the vocational school and the workplace into a single activity system