_ Update Seth Blumenthal, MBA Director, Data & Innovation PCPI

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Presentation transcript:

_ Update Seth Blumenthal, MBA Director, Data & Innovation PCPI Surgical Quality Alliance Washington, D.C. April 24, 2018

© 2018 PCPI Foundation. All rights reserved. What is Registries on FHIR? © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Existing data standards Domain analysis model Input from clinical content experts Implementation guide What is the goal of Registries on FHIR? Registry So that… © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Will contain clinical content Specified in a computable format So database engineers can Implement in registries, EHRs and Other clinical systems FHIR implementation guide containing common data elements Question: What is a common data element? What is the end product of Registries on FHIR? Question: What do we feel this will accomplish? © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. 2017 Published Common Clinical Registry Framework Domain analysis model through HL7 Launched NQRN Interoperability WG with co-chairs Drs. Doug Fridsma, Frank Opelka Completed information-gathering campaign to identify Registry interoperability needs.* 2018 Developed draft CDE spec, beginning with ONC 2015 CCDS and in collaboration with MDEpiNet Secured Pew contract with DCRI/PCPI Conducted working session at PCPI Spring conference Work to date *AMIA 2018 Informatics Summit proceedings © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Output from three breakout sessions Clinical content Multiplicity of standards with ever-changing models Disconnect between registry developer, eCQMs, EHRs Session attendees provided feedback to help refine common data elements pertinent to registries, and CDE metadata Collecting current case forms in Pew-funded study March 19, 2018 working session @ PCPI Notable discussions on individual elements: Patient name – need unique identifier and specific format (Cures act) Birth sex – may also need gender DOB – time? Gestational age? Preferred language – drop this Race – CDC standard short list is the convention in registries Smoking status – needs additional work Lab tests – don’t separate values and results Vital signs – BMI? Methods/devices? Meds – is class needed? Context? © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Output from three breakout sessions Implementation Common Clinical Registry Framework project Registry FHIR specification project (to be launched) Registry FHIR demonstration project (to be launched) CDEs -> logical information models: The Clinical Information Interoperability Council March 19, 2018 working session @ PCPI Major implementation factors discussed: Stakeholder impact – registry stewards, registry vendors, EHR vendors, registry participants and users Process workflow – source data collection, data submission preparation, registry data submission Data quality - completeness, accuracy, Timeliness, Validity, and Consistency © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Output from three breakout sessions Marketing & Governance PCPI not creating additional governance structures Will use HL7 and CIIC for governance PCPI will help with marketing March 19, 2018 working session @ PCPI Major dimensions discussed: Priority audiences – registries, health systems, users, vendors, payers, regulators Value Proposition – lower participation costs, increased analytic power across data silos. Study this – get cost estimates, demonstrate potential through pilot, burden, assess ability to correlate data across registries Marketing Activities - collateral Governance – through CIIC © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Metadata for each concept Category Term/ Attribute Name Attribute Definition Data Type FHIR Coded value or Value Set References Data element concepts Lab tests Lab results Vital Signs Panel Respiratory rate Heart rate Oxygen saturation in Arterial blood by Pulse oximetry Body temperature Body height Body length Head circumference Body weight Body mass index Blood pressure systolic and diastolic Systolic blood pressure Diastolic blood pressure Procedures Care team members Immunizations Device identifier Assessment and plan of treatment Goals Clinical notes Provenance Format: Excel spreadsheet Draft common clinical data set © 2018 PCPI Foundation. All rights reserved.

© 2018 PCPI Foundation. All rights reserved. Rest of 2018 Continue to refine common clinical dataset with feedback from working session Pilot the dataset in registries and source data systems Study current variance in registry data models with regard to these data elements, and look at impact of the pilot on things like need for custom interfacing, chart abstraction, data quality Submit study results for publication Update the domain analysis model and develop the FHIR implementation guide for these data elements 2019 and beyond Push for adoption in NQRN registries Use lessons learned to look for next opportunities Next Steps © 2018 PCPI Foundation. All rights reserved.