Query HealthTechnical WG

9/14/2011

Agenda

Topic Time Allocation

Administrative Stuff and Reminders 11:05 – 11:10 am

Summer Concert Series Patterns Discussion 11:10 – 11:25 am

Existing Standards Discussion 11:25 am – 11:40 am

Abstract Model Discussion 11:40 – 11:55 am

Administrative Stuff and Reminders• Provide feedback on the Project Charter

• Provide feedback on the Technical Principles

• Sign up for the Parallel Work Streams related to

• Summer Concert Series Patterns

• Existing Standards and Models

Summer Concert Series Patterns Template

Component Most Common Pattern Impact to Query Health Standards and Specifications

CIM Data Elements

CIM Vocabularies Management

Query Composition Interfaces

Transport Security

Authentication

Authorization

Organizational Structure

Data Repositories and Sources

Query Submission workflows

Query Results delivery workflows

Summer Concert Series Patterns – hQuery Example

• http://wiki.siframework.org/Summer+Concert+Series+Patterns+and+Summary

Summer Concert Series Patterns Summary

Component Most Common Pattern Impact to Query Health Standards and Services

CIM Data Elements Patient Demographics, medications, allergies, procedures, Chief Complaint, vital signs

Should focus on re-using these from the summer concert series along with ToC Initiative outputs

CIM Vocabularies Management

Locally maintained mappings to HIT standards or Network agreed upon standards. (Most common ICD-9, SNOMED, RxNorm)

Need to determine direction to move forward, should we use NLM – UMLS based vocabulary as the base set ??

Query Composition Interfaces

Portal / Web based interfaces exposing CIM / Vocabulary in intuitive way

Need to ensure our CIM is easily exposable by simple graphic tools

Transport Security TLS based HTTPS connections, Single Hops Query Health should be designed for multiple hops on the internet and end to end security.

Authentication User – Login + Pwd (Single Factor) System – System communications are using system accounts within the network.

Query Health standards should allow flexibility of user authentication, but develop common system – system authentication mechanisms using PKI type of technology.

Authorization User – RBAC based authorizationSystem – System authorization using SAML assertions

Query Health standards should allow multiple levels of trust and authorization as required by organizations policies.

Organizational Structure Network of participants with common data sharing agreements

Should allow networks like State HIE’s, HISP’s to exist and provide these types of services and should not require a network to pre-exist

Data Repositories and Sources

Distributed Data Sources Aligns with Query Health objectives, In addition Query Health should plan to allow data aggregation.

Query Submission workflows

Queries created and distributed via shared portals after piloting on 2 – 3 sitesQueries downloaded by network participants to execute using nightly jobs

Standards should allow creation of portals but should not require existence of portals; may include review of the query prior to submission

Query Results delivery workflows

Queries run asynchronously and post results / status to shared portal where results/status are viewed

Standards should allow creation of portals but should not require existence of portals; may include manual review prior to release of results

Open Discussion• Feedback on the template

• Volunteers to develop and refine the summary

Existing Standards Discussion

• http://wiki.siframework.org/Query+Health+-+Existing+Standards+and+Models+Landscape

• Discussion on content posted

• Feedback on the content posted

• Volunteers to develop and refine the content

Abstract Model Discussion

• Message Exchange Patterns Discussion• http://

wiki.siframework.org/message/view/Summer+Concert+Series+Patterns+and+Summary/42151860

• Abstract Model wiki

• http://wiki.siframework.org/Query+Health+Abstract+Model+and+Terminology

Query Health Standards and Specifications Focus Areas

EMR/Clinical Systems

Organization A (Query Responder)

Reference Implementation

Query Requester

(Consumer)1- Clinical Data Push

4 – Release Results after internal review

2 – Submit Query

3 – Initial Response (Subscription information)CIM

Query Health Data Element Definition Focus

Query Health – Abstract Model

Query Health Standards and Specifications Focus Areas

EMR/Clinical Systems

Organization A (Query Responder)

Reference Implementation

Query Requester

(Consumer)

1- Clinical Data Push

4b – Release Results after internal review

2a – Submit Query

3 – Initial Response (Subscription information)

CIM

Query Health Data Element Definition Focus

Query Health – Abstract Model with Intermediary or Data Aggregator

Intermediary (Data

Aggregator)

EMR/Clinical Systems

Organization B (Query Responder)

Reference Implementation

1- Clinical Data PushCIM

2b – Submit Query

2b – Submit Query

4a – Release Results

4a – Release Results

Query Health – Abstract Model Terminology

Query Requester (Consumer)- Organization or person composing the query for delivery to the Query Responder

Query Responder- Organization that responds to the Query by executing the query on the data source and

returns results.

Intermediary (Data Aggregator)- Organization that is serving as a trusted Third Party or data aggregator for multiple

organizations.

Clinical Information Model- The Model which will be used to write queries against.

Submit Query Interaction:- Interaction that delivers the query from the Query Requestor to the Query Responder.

Initial Response to Query Interaction:- Interaction that delivers initial response from Query Responder or Intermediary to Query

Requestor.

Query Results Delivery Interaction:- Interaction that actually delivers the Results of the Query.

Query Health – Standards and Specifications Focus Areas

13

Interaction/Definition Standard / Specification Purpose Existing Work that can be leveraged

Clinical Data Push (Interaction 1)

Transport and Security Specification

Standard to be used to push information from EMR to Query Health

Clinical Data Push (Interaction 1)

Data Packaging Specification Standard to package data being sent from EMR to Query Health

CIM (Interaction 1) Clinical Information Model Definition

Definitions of data elements to be used within Query Health to support queries

Query Health Request / Initial Response (Interactions 2 and 3)

Transport and Security Specification

Standard to submit a query and obtain an initial response to destination organization or a trusted intermediary

Query Health Request / Initial Response (Interactions 2 and 3)

Data Packaging Specifications Specification to support Query formats and obtain responses which may include TOPIC’s, Links to poll periodically etc.

Results Notification and Delivery (Interaction 4)

Transport and Security Specification

Standard to be used to push notification or results from Query Health to Consumer

Results Notification and Delivery(Interaction 4)

Data Packaging Specifications Specification to support Query results content or URI’s pointing to Query Results

Next Steps

• Post any comments on the project charter and technical principles

• Volunteers to develop and Refine the Patterns Summary to be presented next week

• Volunteers to develop and refine the existing standards to be presented next week

• Volunteers to develop and refine the abstract model and terminology to be presented next week

Using the Discussion Tab on Wiki to Leave Comments

15

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