Query Health Technical WG 9/14/2011

Agenda TopicTime Allocation Administrative Stuff and Reminders11:05 – 11:10 am Summer Concert Series Patterns Discussion11:10 – 11:25 am Existing Standards Discussion11:25 am – 11:40 am Abstract Model Discussion11:40 – 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 ComponentMost Common PatternImpact 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

Summer Concert Series Patterns Summary ComponentMost Common PatternImpact to Query Health Standards and Services CIM Data ElementsPatient 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 SecurityTLS based HTTPS connections, Single HopsQuery Health should be designed for multiple hops on the internet and end to end security. AuthenticationUser – 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. AuthorizationUser – RBAC based authorization System – System authorization using SAML assertions Query Health standards should allow multiple levels of trust and authorization as required by organizations policies. Organizational StructureNetwork 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 SourcesAligns 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 sites Queries 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 +Existing+Standards+and+Models+Landscapehttp://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 rt+Series+Patterns+and+Summary/ http://wiki.siframework.org/message/view/Summer+Conce rt+Series+Patterns+and+Summary/ Abstract Model wiki gyhttp://wiki.siframework.org/Query+Health+Abstract+Model+and+Terminolo gy

Query Health Standards and Specifications Focus Areas EMR/ Clinical Systems EMR/ Clinical Systems Organization A (Query Responder) Reference Implementation Query Requester (Consumer) 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 EMR/ Clinical Systems Organization A (Query Responder) Reference Implementation Query Requester (Consumer) 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 EMR/ Clinical Systems Organization B (Query Responder) Reference Implementation 1- Clinical Data Push CIM 2b – Submit Query 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/DefinitionStandard / SpecificationPurposeExisting 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 SpecificationStandard 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 SpecificationsSpecification 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 SpecificationsSpecification 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

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