CLINICAL DECISION SUPPORT PLATFORM (242)    PACKAGE (9.4)

Clinical Decision Support Platform is the core system to power Clinical
interact with electronic health record data, as well as specific
applications providing clinical decision support such as Covid-19 Patient
Manager (CPM), Lung Cancer Screening Platform (LCSPv2).
 
This patch will distribute an updated Option CDSP RPC CONTEXT. The OPTION 
CDSP RPC CONTEXT contains additional RPCs, all of which have new approved 
Integration Agreements.These additional RPCs will enable new Applications
to be launched from the Clinical Decision Support Platform as listed below.
 
Lung Cancer Screening Pv2: TIU CREATE RECORD Text Integration Utility and 
Decision Support (CDS) applications. This platform enables rapid
PXRPC SAVE2 Patient Care Encounter. These RPCs will give the Lung Cancer
Screening App the ability to create TIU Documents that document actions 
taken during a LCSPv2 encounter.
 
Precision Oncology: ORWPT LIST ALL Order Entry Results Reporting. Get and 
filter list of patients. This RPC returns a set of patient names for use 
with a long list box for selection by the user.
 
Clinical Decision Support Platform: VPR GET PATIENT DATA JSON Virtual 
Patient Record. This RPC will be added to supports APPs such as Lung 
development and deployment of applications that follow Substitutable
Cancer Screening and Precision Oncology. The RPC is to be used as an 
alternative to VPR GET PATIENT DATA, which returns data in XML.  There 
are frameworks identified where XML libraries often have vulnerabilities 
(expat and friends) and deserializing XML is more difficult than JSON.
 
Clinical Decision Support Platform: LHS CHECK OPTION ACCESS Lighthouse. 
This RPC scours Primary Menu Options, Secondary Menu Options and Common 
Options to determine if the DUZ passed in has access to the option passed 
in.
 
Medical Applications and Reusable Technologies (SMART) family of 
Task Manager: Several OR Team access RPC are being added to streamline 
patient selection.
standards such as SMART on FHIR (Fast Healthcare Interoperability
Resources) and CDS Hooks. CDSP facilitates the launch of CDS applications
from within the VA Electronic Health Record (EHR) - CPRS and Clinical
Context Management (CCOW) vault patient context synchronization. The
system encompasses technical infrastructure and shared capabilities to

This patch will install additional necessary components to support the 
Interoperability Resources) and CDS Hooks. CDSP facilitates the launch of 
CDS applications from within the VA Electronic Health Record (EHR) - 
CPRS. The CDS Platform also relies on the Clinical Context Management 
(CCOW) vault to carry patient context and the synchronization of the 
selected patient between CPRS and the CDS Platform and thus CDS App 
launched from the CDS Platform. The system encompasses technical 
infrastructure and shared capabilities to interact with electronic health 
record data, as well as specific applications providing clinical decision 
support such as Covid-19 Patient Manager (CPM), Lung Cancer Screening 
Risk Calculator.  
Clinical Decision Support Platform (CDSP).  
 
The CDSP RPC CONTEXT menu option contains the following RPCs. The RPCs 
added with this patch are listed below with the Integration Control
Agreement number.
 
Added with CDSP*1.0*2 
1635:  TIU GET RECORD TEXT 
3954:  TIU SET DOCUMENT TEXT 
1790:  TIU SIGN RECORD 
3194:  TIU AUTHORIZATION 
 
6083:  TIU GET DOCUMENT STATUS 
1841:  ORWRP REPORT TEXT 
CDSP is the core system to power Clinical Decision Support (CDS) 
applications. This platform enables rapid development and deployment of 
applications that follow Substitutable Medical Applications and Reusable 
Technologies (SMART) family of standards such as SMART on FHIR (Fast 
Healthcare  
 

1. Overview
on FHIR and CDS Hooks specifications. CDSP enables the launch of CDS 
 
EHRM Impact Statement:
----------------------
There is no anticipated impact to EHRM sites, and can be installed at all
EHRM converted sites. 
applications from within the Computerized Patient Record System (CPRS) 
and maintains patient context through Clinical Context Management (CCOW) 
integration.
 
2. Functional Changes:
A post-initialization routine is included with this patch. The routine 
installs two new entries in the REMOTE APPLICATION file (#8994.5).
The REMOTE APPLICATION file was introduced as part of the Broker Security 
Enhancement to support secure access through remote user or visitor 
This patch enhances the Clinical Decision Support Platform (CDSP) by
mechanisms used by GUI applications. This entry will allow a user to 
authenticate with 2-factor authentication in one VistA system (home),
and visit another VistA system (remote) using a BSE token. This is done in 
accordance with instructions on the use of the Broker Security Enhancement
(BSE) as provided by RPC Broker software documentation. (VORB Approval #:
VORB-76, VORB-77) These entries enable the use of a Non-Person Entity 
(NPE) account to support:
        Non-interactive user workflows
        Interactive user workflows
Access is controlled through two menu options CDSP RPC CONTEXT and CDSP
installing additional infrastructure components, security configurations, 
SERVICE CONTEXT. At this time, the new CDSP SERVICE CONTEXT option mirrors
the existing CDSP RPC CONTEXT option. This new option is required to
support the two new Remote Application entries in file #8994.5 and to
facilitate proper Broker context assignment.
 
3. RPC Changes:
Five new RPCs are added to CDSP RPC CONTEXT and CDSP SERVICE CONTEXT menu
option.
ICN     RPC Name
4679    VAFCTFU CONVERT ICN TO DFN
menu options, and Remote Procedure Calls (RPCs) required to support 
3209    DDR GETS ENTRY DATA
3403    DG SENSITIVE RECORD BULLETIN
3402    DG SENSITIVE RECORD ACCESS
3221    DDR LISTER
 
Existing RPCs Attached to both CDSP RPC CONTEXT and CDSP SERVICE CONTEXT, 
and they are listed below as a refresher.
ICN    RPC Name
4680   VAFCTFU CONVERT DFN TO ICN
6022   VPR GET PATIENT DATA
current functionality and future platform enhancements.
5532   XUSGET VISITOR
2857   XUS GET USER INFO
5501   XUS SET VISITOR
3291   ORWPT LAST5
4907   ORWPT SELECT
1836   ORWU NEWPERS
3210   TIU UPDATE ADDITIONAL SIGNERS
4680   VAFCTFU CONVERT DFN TO ICN
6022   VPR GET PATIENT DATA
5532   XUSGET VISITOR
CDSP is the enterprise platform that enables the development and 
2857   XUS GET USER INFO
5501   XUS SET VISITOR
3291   ORWPT LAST5 
4907   ORWPT SELECT
1836   ORWU NEWPERS
3210   TIU UPDATE ADDITIONAL SIGNERS 
7443   ORWPT GET FULL ICN
7315   PXRPC SAVE2
1806   TIU CREATE RECORD
7481   LHS CHECK OPTION ACCESS
deployment of Clinical Decision Support (CDS) applications. The platform 
4746   VPR GET PATIENT DATA JSON
1685   ORWPT LIST ALL
1684   ORWPT ID INFO
7490   ORWTPT GETTEAM
7489   ORWTPT ATEAMS
1656   ORQPT TEAM PATIENTS
3194   TIU AUTHORIZATION
6083   TIU GET DOCUMENT STATUS
1635   TIU GET RECORD TEXT
3954   TIU SET DOCUMENT TEXT
supports applications built in accordance with Substitutable Medical 
1790   TIU SIGN RECORD
1841   ORWRP REPORT TEXT
4679   VAFCTFU CONVERT ICN TO DFN
3209   DDR GETS ENTRY DATA
3403   DG SENSITIVE RECORD BULLETIN
3402   DG SENSITIVE RECORD ACCESS
3221   DDR LISTER
 
4. Impact on System:
This patch: 
Applications and Reusable Technologies (SMART) standards, including SMART 
-Enhances CDSP infrastructure to support future platform
 capabilities. 
-Implements secure Remote Application entries for Broker-based
 authentication. 
-Introduces new service context options to support NPE-based workflows.
-Adds five new RPCs required for CDSP functionality.
 
CPRS Impact:
------------
There is no anticipated impact to existing CPRS functionality.