Data Access Framework All Hands Community Meeting July 23, 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” From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

Agenda TopicEstimated Time Launch Standards Selection Process for Data Elements45 minutes Next Steps/Questions5 minutes 3

Create IG based on existing standards WP Comme nt Period Notional Project Timeline S&I Lifecycle (Discovery  Pilot & Evaluation) Today 7/23 August November September OctoberDecember DAF/IHE White Paper Published July 2014 Implementation (DAF/IHE Community) DAF IHE/ S&I Joint Work Group IHE Activities Document IG Consensus Implementation (S&I Community) Candidate Standards Analysis Finalize Actors + Transactions + Technology Stacks and Standards TWG 2: Data Element based access for LDAF & TDAF Creating Operation Plan for Pilot Testing Balloting Activities Pilots and Testing Pilots & Testing Create IG Creating Operation Plan for Pilot Testing Pilots & Testing Pilots and Testing Balloting Activities Data Element IG Consensus IHE Trial Impleme ntation Meeting TWG 1: Document Metadata based access for LDAF & TDAF

5 DAF Data Elements Standards Selection The DAF standards comparison spreadsheet is posted to the Harmonization section of the DAF wikipage Please visit the following link to submit your comments: n+and+Implementation#Comment n+and+Implementation#Comment

All standards identified by the community have been discussed – FHIR – QUICK – QED – HL7v2.x – HQMFv2 Need to start narrowing down to a single standard from the existing set of candidates. – Standards selected may still need to be enhanced to satisfy DAF requirements – Profiles may be required to create an implementable IG Candidate Standards Discussed … 6

Early decision to not pursue further analysis of HQMFv2 due to – Its focus on quality measures – Complexity of creating queries – Document Paradigm – Not completely computable – Results are to be obtained using other types of documents such as QRDA Category I, QRDA Category III, C-CDA etc. HQMF v2 7

QED - SWOT Strengths Nearly same XML as CCD/IHE XPHR Identical Constraints Supports Linkage to Document Weaknesses Needs update to Standard (based on DSTU) No Population Level Query Support No Pub/Sub Support Opportunities Some limitations removed with Standard RESTful/FHIR Update Threats FHIR Efforts More Interesting Limited Adoption 8 RESTful QED looking at FHIR as an option to adopt

QUICK Quality Improvement Clinical and Knowledge model – QUICK = Harmonization of vMR and QDM with mappings to FHIR – Objective is to use the model in clinical quality artifacts In expressions and criteria for eMeasures, CDS artifacts Hence, the model is tuned for that purpose – Objectives of Mapping to FHIR Interoperability Gain physical format, API – CQL complements FHIR and does not replace it. (Enables complex queries) This expression is used in knowledge artifacts. The execution of this artifact may leverage FHIR to obtain the data for use within the reasoning engine. – S&I CQF is going to leverage FHIR to implement QUICK/CQL

HL7v2.x Query Specification Formats – Query by Simple Parameters – Query by Example Variant – Query by Using the QSC Variant Query profiles will be required to be created similar to the Immunization profile 12/7/201510

Discussion to Narrow Down the Standards 11 FHIR seems to be emerging as a leading candidate – QED/QUICK adopting FHIR in the near future or as part of the roadmap – Is the emerging standard backed by industry support – Is in sync with FACA guidance to embrace RESTful approaches HL7v2.x seems to be the other alternative to puruse Strawman Poll: – Pursue FHIR for Simple DAF Data Element Queries using existing DSTU and create profile and IG as needed – Monitor CQL and how it evolves as a Query syntax for complex queries instead of developing a parallel query syntax

Questions 12

Data Access Framework Resources DAF Wiki Homepage – Become a Community Member – e e DAF Charter – mbers mbers DAF Standards, Harmonization and Implementation Activities – mentation mentation Standards and Interoperability(S&I) Framework – S & I Calendar of Events –

Initiative Support Leads For questions, please feel free to contact your support leads: – Initiative Coordinator: John Feikema – ONC Sponsors: Mera Choi – Support Team: Project Management: – Gayathri Jayawardena Technical Support: – Dragon (Nagesh) Bashyam Standards SME: – Ed Larsen Standards Support : – Angelique Cortez Vocabulary and Terminology Subject Matter Expert: – Mark Roche, MD 14