NextMed (WIP)

   

Nex Med CDS

The purpose of NexMed CDS is to provide an extension to the Roche Diabetes Care Platform (RDCP).

NexMed is a data driven Clinical Decision Support (CDS) tool that guides physicians at the point of care to make personalized therapy decisions for NIDDM (Non-insulin-dependent diabetes mellitus) patients.

NexMed CDS follows the unified pharmaco-therapy guidelines recommended by American Diabetes Association (ADA) / European Association for the Study of Diabetes (EASD).

Taking into consideration the patient’s characteristics the solution guides the HCP through a step wise approach for therapy selection from Metformin mono-therapy all the way up to insulin initiation. The HCP manually enters the required data and the solution provides the appropriate therapy recommendation.

Key capabilities to be delivered for 1.0 release include:

  • Manual entry of data required for processing the algorithm
  • Connectivity to the data storage of RDCP
  • Suggestion of the most suitable OAD at a class level

Requirements

The NexMed Application is a new independent software module within RDCP. This module aims to deliver personalized therapy recommendations to HCPs for Type 2 Diabetes Mellitus (T2DM) patients by suggesting the most suitable medications based on ADA-EASD guidelines and individual patient characteristics.

Scope for FHIRSTACK

  • Model the data elements needed to support NexMed so that they can stored and retrieved by NexMed

  • The output of NexMed needed to be modeled, stored and retrieved.  This output comes in the form of a document that contains the medication class level (chemical/therapeutic/pharmacological subgroup ATC code level = 4).

Data Points

Data Point Description FHIR Resource & Element Remarks FHIR Sample
Diagnostics -> Diabetes Type Patient list of diabetes type Condition Sample
Diagnostics -> Albuminuria Indicates if the Albuminuria Disease is present Condition Sample
Diagnostics -> ASCVD (Atherosclerotic Cardiovascular Disease) Boolean which identifies if Atherosclerotic Cardiovascular Disease predominates over other comorbidities Condition Sample
Diagnostics -> CKD (Chronic Kidney Disease) Boolean which identifies if Chronic Kidney Disease predominates over other comorbidities Condition Sample
Diagnostics -> DKD (Diabetic Kidney Disease) Boolean which identifies if Diabetic Kidney Disease predominates over other comorbidities Condition Sample
Diagnostics -> HF (Heart Failure) Boolean which identifies if Heart Failure predominates over other comorbidities Condition Sample
Diagnostics -> Pregnancy Boolean which identifies if Pregnancy predominates over other comorbidities Condition Sample
Medications -> Current Drug Class name Indicates the class of the current medications which is currently beeing taken by the patient (GLP-1, SGLT2i, etc) Substance Sample
Diagnostics -> HbA1C (current) Indicates the glycated haemoglobin average blood glucose levels for the last 2-3 months Laboratory_Observation Sample
Diagnostics -> Serum Creatinine Indicates the measurement of this chemical compound (creatinine) in blood (serum) Laboratory_Observation Sample
Diagnostics -> Albumin Indicates the measurement of the amount of protein in the urine Laboratory_Observation Sample
Diagnostics -> eGFR* eGFR is short for estimated glomerular filtration rate Laboratory_Observation Sample
Diagnostics -> Height Patient Height Vital signs Observation Sample
Diagnostics -> Weight Patient weight measured Vital signs Observation Sample
Diagnostics -> BMI Patient BMI Vital signs Observation Sample
Careplan -> HbA1c target Indicates the individual target for the glycated heamoglobin average blood glucose levels Goal (referenced in CarePlan) Sample

Assumptions:

  • eGFR is a calculated value based on the age, gender, race and creatinine value.
  • No comorbidities does not need to be modeled or stored