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Meeting Etiquette. Please announce your name each time prior to making comments or suggestions during the call 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 - PowerPoint PPT Presentation
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Meeting Etiquette• Please announce your name each time prior to making comments or
suggestions during the call• 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 meetings, is being recorded– Another reason to keep your phone on mute when not speaking!
• Feel free to use the “Chat” or “Q&A” feature for questions or comments, especially if you have a bad phone connection or background noise in your environment
NOTE: This meeting is being recorded and will be posted on the Wiki page after the meeting
From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute
RESTful Health Exchange (RHEx)Content ApproachWebEx #5
August 23, 2012
Powering Secure, Web-Based Health Data Exchange
wiki.siframework.org/RHEx
3
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
What is RESTful Health Exchange (RHEx)?
• An open source, exploratory project to apply proven Web technologies to demonstrate a simple, secure, and standards-based health information exchange
• Sponsored by the Federal Health Architecture (FHA) program in FY12– Helps to address Nationwide Health Information Network (NwHIN)
Power Team recommendation to develop a specification for RESTful exchange of health data
– Informs a path forward for a RESTful health data exchange
• Demonstrates RESTful health information exchange in two phases– Phase 1: Security and Transport Approach (April-July 2012)
– Phase 2: Content Approach (July-September 2012)
4wiki.siframework.org/RHEx
5
RHEx Architecture Stack
Phase 1
Phase 1
Phase 2
6
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
7
Components of the RHEx Content Layer
ContentOrganization
Content Payload
What data will be exposed?
How should data be organized and
managed?
8
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
9
Content Organization Goals
• Establish traversable hierarchical organization of data
• Provide common structured interaction using standard HTTP methods and RESTful Principles
• Support representation of data at appropriate levels of granularity aligned with Use Case– TATRC Pilot Use Case (discussed later in briefing)
10
Content Organization Options
• Atom Publishing Protocol (AtomPub)
– Original Web 2.0 protocol for publications and posting on Web resources
• Open Data Protocol (OData)
– Extends AtomPub
– Data represented by Entity Data Model
– Provides specificity at the field and data type levels
– Not healthcare specific
• hData
– Similar to AtomPub, but more constrained
– Data can be represented using multiple standards
– Provides specificity at the granular document levels
– Developed with healthcare domain in mind• Hierarchical structure supporting linked documents
• Provides a means for discoverability of changed content
– Can interoperate with other protocols• OData can be integrated in the hData hierarchy
• Fast Healthcare Interoperability Resources (FHIR) Content Profile can be developed
11
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
12
Content Payload Goals
• Establish Common Data Model for Exchange– Semantic and Syntactic Interoperability
• Use existing standards• Provide extensible solution to manage multiple data
standards• Align content with use case
– TATRC Pilot Use Case (discussed later in briefing)
13
Content Payload Options
• Healthcare Standards– HL7 CDA
• HITSP C83/C80/C154/C32• greenCDA for C32
– HL7 2.6 REF_I12– HL7 V3
• REPC_MT210001UV
– Consolidated Clinical Document Architecture (CDA)– DICOM
14
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
TATRC Pilot Motivation
• Pilot is designed to develop proof of concept for a World Wide Web model for health data exchange– Test the application of REST to health data exchange– Help to address the NwHIN Power Team recommendation
• Worked with selected federal partners to identify critical capability gap and select a prototype use case– Consult results are not consistently sent to PCP today,
impacting healthcare for Veterans and Service Members• Phase 2 pilot designed to evaluate Content Organization
and Payload concepts
15
TATRC = Telemedicine & Advanced Technology Research Center
consult results
TATRC Pilot Use Case – Consult/Referral
16
PCP Consulting Physician
consult request
PCP = Primary Care Physician URL-1 = Consult Requests Details URLURL-2 = Consult Results Details URL
URL-2Message
MessageURL-1
URL-1
URL-2
URL-1
17
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
18
RHEx Content Approach in TATRC Pilot
• Context– Designed to summarize a patient’s electronic health record
for the purpose of clinical consultation and referral– Components were modeled to support pilot use case:
specialist consultation for knee replacement • Content Organization choice:
– Hybrid approach• Patient data is organized into an hData Record on the Consulting
Provider’s EHR– Each section has zero or more entries– Unique Uniform Resource Identifier (URI) links are used for authorized patient record
data access
• Patient data is exposed as links to greenC32 representations on PCP EHR
• Content Payload choice:– greenC32 schemas used as content payload
19
Approach to Content Organization, 1 of 2
hData Abstract Content Model Diagram
Supports coarse documents
OData could be implemented as a Section Feed
Supports hierarchy of patient data
Describes content available and resource URIs
URIs can point to DICOM images or granular patient data, such as allergy or medication
20
Approach to Content Organization, 2 of 2
Course Grained Link Example
Granular Content Link Example
21
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
RHEx TATRC Pilot Phase 2 Model Vision
22
greenC32
Patient
Procedures
Allergies
Medications
Lab Results
Vital Signs
PCP EHR Consulting Provider EHR
23
RHEx Content Payload for TATRC Pilot
Existing data standards
Resource Directory Description Language
24
Overview
• Orientation– What is RESTful Health Exchange?– RHEx Architecture Stack
• The RHEx Content Layer– Content Organization– Content Payload
• RHEx Content Approach in TATRC Pilot– Content Organization– Content Payload
• Questions and Wrap-up
25
Summary
• RHEx Content Layer includes Content Organization and Payload– Options exist for each
• Concepts for Content Organization and Payload are being evaluated in the TATRC Pilot– Hybrid approach to Content Organization
• hData is used as the Content Organization for RHEx at Consulting Provider
– Supports multiple data standards– Developed with healthcare domain in mind
• greenC32 sections represented at Primary Care Provider
– greenC32 used for Content Payload• Builds on existing standards• Provides a format that is easier for developers to use
Questions & Wrap-up
• Questions?
• For more information: – http://wiki.siframework.org/RHEx
• Discussion on the Google Groups forums:– https://groups.google.com/forum/?fromgroups#!forum/restfulhealthexchange
26
BACKUPS
27
28
Green Process