Data Access Framework All Hands Community

Meeting July 9, 2014

Meeting Etiquette• Remember: If you are not speaking, keep your

phone on mute• Do not put your phone on hold – if you need to

take a call, hang up and dial in again when finished with your other call– Hold = Elevator Music = very frustrated speakers and

participants

• This meeting, like all of our meeting is being recorded– Another reason to keep your phone on mute when not

speaking

• Feel free to use the “Chat” feature for questions, comments or any items you would like the moderator or participants to know.

NOTE: This meeting is being recorded and will be posted on the DAF Wikipage, under

“Materials” “Past Meetings”

NOTE: This meeting is being recorded and will be posted on the DAF Wikipage, under

“Materials” “Past Meetings”

From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute

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Agenda

Topic Estimated Time

QED Overview and Application to DAF, Presented by Keith Boone

40 minutes

Next Steps/Questions 5 minutes

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Create IG based on existing standards

Create IG based on existing standards

WP Comme

nt Period

WP Comme

nt Period

Notional Project Timeline S&I Lifecycle

(Discovery Pilot & Evaluation)Today

7/9August Novemb

erSeptember

October December

DAF/IHE White Paper Published

July2014

Implementation (DAF/IHE

Community)

Implementation (DAF/IHE

Community)

DAF IHE/ S&I Joint Work GroupIH

E A

cti

vit

ies

Document IG

Consensus

Implementation (S&I Community) Implementation (S&I Community)

Implementation (S&I Community) Implementation (S&I Community)

Candidate Standards Analysis

Candidate Standards Analysis

Finalize Actors + Transactions +

Technology Stacks and Standards

Finalize Actors + Transactions +

Technology Stacks and Standards

TW

G 2

: D

ata

Ele

men

t b

ased

access f

or

LD

AF &

TD

AF

Creating Operation Plan for Pilot Testing

Creating Operation Plan for Pilot Testing

Balloting Activities

Pilots and TestingPilots and Testing

Pilots & Testing Pilots & Testing

Create IGCreate IG Creating Operation Plan for Pilot Testing

Creating Operation Plan for Pilot Testing

Pilots & Testing Pilots & Testing

Pilots and Testing

Pilots and Testing

Balloting Activities

Data Element IG Consensus

IHE Trial Implementation

Meeting

IHE Trial Implementation

Meeting

TW

G 1

: D

ocu

men

t M

eta

data

based

access f

or

LD

AF

& T

DA

F

5

QED

Analysis and DAF Application provided by IHE PCC Technical Committee member, Keith

Boone

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Query for Existing DataValue Proposition

• Exchange of information between Data Repositories and Clinical Data Consumers for:– Drug Safety– Public Health, Biosurveillance and Disease Registries– Identifying Qualifying Patients

• Clinical Trials• Disease Management

– Quality Reporting– Claims Submission– Decision Support Systems

• Using a single standard for query • Compatible with CCD

vs.• 30-60 HL7 V2.X Interfaces @ $10-20K/Inteface

HITSP TP21, QualityHITSP TP21, Quality

Scope• Problems and Allergies

– Disease Registries, EHR Systems, CDS• Vital Signs

– Monitoring Systems, EHR Systems, CDS• Diagnostic Results

– Laboratory and Radiology Information Systems, EHR Systems, CDS

• Medications– Pharmacy, EHR Systems, CDS

• Immunizations– Immunization Registries, EHR Systems, CDS

• Professional Services– Practice Management, Scheduling Systems, Care

Management, CDS

Key Technical Properties

• Support for Web Services and SOA Architecture• Use of one standard for all queries• Reuse of PCC Technical Framework Templates• Compatibility with ASTM/HL7 CCD

QED Actors/Transactions

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Data Elements (1)Common Observations •Simple measurements or reported values that can be determined using simple measuring devices (e.g., Height, Weight), or which can be reported by the patient (e.g., date of last menstrual period).

Diagnostic Results •Observations made or performed using laboratory testing equipment, imaging procedures, vision examinations, et cetera.

Problems and Allergies•These are a collection of diagnoses, clinical findings, allergies, or other risk factors that are recorded for the patient. The information may be obtained from patient reports, or through clinical decision making.

– Conditions: Disease conditions for the patient. – Intolerances: Allergies and other intolerances. – Risk Factors: Significant risk factors based on family history, social history, occupational exposures, et

cetera.

Medications •Medications that a patient is or has been taking for treatment of one or more conditions.

Immunizations •Immunizations that have been given, or which are planned to be given to the patient.

Professional Services  •Procedures and/or encounters which the patient has participated in, or is expected to participate in.

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Data Elements (2)

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Information Category Code Returns Template Id

Vital SignsCOBSCAT All Vital Signs Vital Signs Observation

Any Code from the Vital Signs Table below The vital sign identified by the code Vital Signs Observation

Problems and Allergies

MEDCCAT All problem entries Problem Entry

CONDLIST All Concern Entries Concern Entry

PROBLIST All Problem Concerns Problem Concern

INTOLIST All Allergy Concerns Allergy and Intolerance Concern

RISKLIST All Risks1 Concern Entry

Diagnostic ResultsLABCAT All Lab Results Simple Observations

DICAT All Imaging Results Simple Observations

Medications

RXCAT All Medications Medications

MEDLIST All Medications Medications

CURMEDLIST All active medications Medications

DISCHMEDLIST Discharge Medications Medications

HISTMEDLIST All Historical Medications Medications

Immunizations IMMUCAT All Immunizations Immunizations

Professional Services PSVCCAT All professional service entries Encounters Procedures Entry

Query Interaction

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Query Syntax (1)

13

Query Syntax (2)

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Query Results (1)

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Query Results (2)

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Adoption

• Two Published Integration Statements– Orion Health– IntercomponentWare AG– See http://product-registry.ihe.net

• Five Vendors Tested at IHE Connectathon– http://connectathon-results.ihe.net/view_result.php?rows=compa

ny&columns=actor&title=integration_profile&integration_profile=QED

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Provenance/Security Metadata

Provenance•Author•Verifier•Responsible Party•Patient/Subject

Tags•Confidentiality

Can be Grouped with other Actors providing addition user metadata (e.g., XUA, IUA)

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SWOT

StrengthsNearly same XML as CCD/IHE XPHRIdentical ConstraintsSupports Linkage to Document

WeaknessesNeeds update to Standard (based on DSTU)No Population Level Query SupportNo Pub/Sub Support

OpportunitiesSome limitations removed with StandardRESTful/FHIR Update

ThreatsFHIR Efforts More InterestingLimited Adoption

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Questions

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Data Access Framework Resources• DAF Wiki Homepage

– http://wiki.siframework.org/Data+Access+Framework+Homepage

• Become a Community Member– http://wiki.siframework.org/Data+Access+Framework+Join+the

+Initiative• DAF Charter

– http://wiki.siframework.org/Data+Access+Framework+Charter+and+Members

• DAF Standards, Harmonization and Implementation Activities– http://wiki.siframework.org/

DAF+Standards+Harmonization+and+Implementation• Standards and Interoperability(S&I) Framework

– http://wiki.siframework.org/Introduction+and+Overview• S & I Calendar of Events

– http://wiki.siframework.org/Calendar21

Initiative Support Leads• For questions, please feel free to contact your support

leads:– Initiative Coordinator: John Feikema john.feikema@siframework.org– ONC Sponsors: Mera Choi mera.choi@hhs.gov– Support Team:

• Project Management: – Gayathri Jayawardena gayathri.jayawardena@esacinc.com

• Technical Support: – Dragon (Nagesh) Bashyam nagesh.bashyam@drajer.com

• Standards SME:– Ed Larsen ed_larsen@comcast.net

• Standards Support: – Angelique Cortez angelique.j.cortez@accenture.com

• Vocabulary and Terminology Subject Matter Expert: – Mark Roche, MD mrochemd@gmail.com

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