1. MDPHnet & ESP Data Partner Participation Overview The following slides describe the necessary steps for a data partner to participate in the MDPHnet Network as a queryable data partner

2. How a site participates as a queryable data partner for MDPHnet Install and configure the ESP server and software Populate the ESP database Develop EHR extract(s) to populate ESP data model and MDPHnet reporting schemas Run processing scripts to load data Set up routine (daily or weekly) data feeds Email monitoring options available Install and configure the Query Tool DataMart Client software Go live! Create, receive, and respond to queries Participate in the MDPHnet community Consider next steps! ESP notifiable disease case reporting, RiskScape, TrimTracker General MDPHNet / ESP Wiki Page with additional resources: https://popmednet.atlassian.net/wiki/display/DOC/MDPHnet

3. Step 1: Install ESP Server and Software Application Identify a LINUX server for the ESP application and database Install and configure a Postgres database, the open source ESP software, and associated infrastructure Implement the UNIX shell scripts to be used for the “care and feeding” of ESP’s processes ESP Website: http://esphealth.org/ESPnet/images/ESP%20Deployment.html http://esphealth.org/ESPnet/images/ESP%20Deployment.html Wiki: https://popmednet.atlassian.net/wiki/display/DOC/ESP%3A+MDPHnet https://popmednet.atlassian.net/wiki/display/DOC/ESP%3A+MDPHnet

4. Step 2: Populate ESP Database Determine data to include in the ETL (extract, transform, load) process from the EHR to ESP Complete data mappings* Run processing scripts to load data Implement the extracts for to populate the MDPHnet reporting schema Set up routine (daily or weekly) data feeds *Note that the level of effort for data mapping will vary depending on the level of MDPHnet participation. For example, a site participating as a queryable data partner requires fewer resources than a site participating in notifiable disease case reporting where lab mapping are much more extensive.

5. Step 3: Validate the EHR to ESP Data Feeds* Activities include: Data mapping reviews Troubleshooting Loading historical data *Note that the level of effort for these activities vary depending on the level of MDPHnet participation. For example, a site participating as a queryable data partner requires fewer resources than a site participating in notifiable disease case reporting.

6. Step 4: Install MDPHnet Query Tool (PopMedNet) DataMart Client In order to receive and respond to MDPHnet queries, the open source DataMart Client software must be installed with the ability to connect to the local ESP data User training and technical support for configuration and query response processes available PopMedNet DataMart Client Overview Wiki: https://popmednet.atlassian.net/wiki/display/DOC/The+DataMart+Client+Appli cation YouTube Video: https://www.youtube.com/watch?v=7eO9Nm7iqxE https://popmednet.atlassian.net/wiki/display/DOC/The+DataMart+Client+Appli cationhttps://www.youtube.com/watch?v=7eO9Nm7iqxE DataMart Client installation and setup Wiki: https://popmednet.atlassian.net/wiki/display/DOC/Configuring+the+DataMart +Client https://popmednet.atlassian.net/wiki/display/DOC/Configuring+your+DataMar ts#ConfiguringyourDataMarts-ESPRequestsandSQLDistributionModelProcessors YouTube Video: https://www.youtube.com/watch?v=HUcAwrU7LLkhttps://www.youtube.com/watch?v=HUcAwrU7LLk

7. Step 5: Go Live as a Queryable Data Partner!* After ESP is installed and the data are populated from the EHR, the Data Partner can receive and respond to MDPHnet queries Query Overviews: https://popmednet.atlassian.net/wiki/display/DOC/Query+Composer+Request https://popmednet.atlassian.net/wiki/display/DOC/ESP+Query+Composer+Projections Review MDPHnet governance document Participate in the MDPHnet community working group Consider next steps! ESP notifiable disease case reporting - https://popmednet.atlassian.net/wiki/display/DOC/ESPnet+Algorithms http://esphealth.org/ESPnet/images/notifiable%20diseases.html https://popmednet.atlassian.net/wiki/display/DOC/ESPnet+Algorithms http://esphealth.org/ESPnet/images/notifiable%20diseases.html RiskScape http://esphealth.org/ESPnet/images/RiskScape.htmlhttp://esphealth.org/ESPnet/images/RiskScape.html TrimTracker *Test environments are available for sites to create, run and respond to queries on synthetic ESP data. Please contact support@popmednet.org if interested.

8. Example Query: MDPH staff or Data Partner* (i.e. requestor) Composes the Query 8 Query Metadata *Data partners currently only have access to query their own data

9. Requestor Composes the Query 9 Criteria Group: Patients with Diabetes

10. Requestor Composes the Query 10 Criteria Group: And Hypertension

11. Requestor Composes the Query 11 Criteria Group: Without Stroke

12. DataMart Administrator Receives the Query 12 DataMart Administrator Inbox

13. DataMart Administrator Reviews Query Details 13 Administrator can review query input

14. DataMart Administrator Executes the Query and Reviews Results 14 …and output

15. DataMart Administrator Uploads Results 15 …and send results back to the requestor

16. Requestor Views Results Requestor can view aggregate views (across all data partners queried), or by individual sites. Projected* and adjusted results are also available. *For more information about the projections functionality, see https://popmednet.atlassian.net/wiki/display/DOC/ESP+Query+Composer+Projections https://popmednet.atlassian.net/wiki/display/DOC/ESP+Query+Composer+Projections

17. Requestor Views State-Wide Projections

18. Requestor Selects a Location

19. Requestor* Views Projections for a Town *The requestor may be a data partner who uses this tool to project the query results of their patient population to nearby towns in their catchment area or other towns of interest.

20. MDPHnet & ESP Data Flow Diagrams Phase 1 Baseline MDPHnet/ESP Implementation: Slide 1: MDPH aggregate querying & reporting – MDPH users querying multiple data partners Slide 2: MDPH aggregate querying & reporting – Data Partners querying their local data Additional Activities that can be implemented over time: Slide 3: MDPHnet aggregate querying & reporting + ESP notifiable disease case reporting Slide 4: MDPHnet aggregate querying & reporting + ESP notifiable disease case reporting + RiskScape + TrimTracker reporting The following slides illustrate data flow processes for the various levels of MDPHnet participation that Data Partners can participate in.

21. MDPHnet Query Tool Request Cycle 21 MDPH PMN DataMart Client 1 1. MDPHnet user creates and submits query to selected sites 2. Individual sites retrieve query 3. Sites review and run query against the ESP database via the PMN DataMart Client 4. Sites review and approve results 5. Individual site returns results via secure network 6. MDPHnet user views results in PMN Portal -Users at Data Partners and MDPH have options to receive query notifications throughout cycle 2 MDPHnet Query Tool Portal 3 4 6 5 PMN DataMart Client ESP Application Server 3 4 PMN DataMart Data Partner1 Data Partner 2 PMN DataMart EHR *Workflow includes aggregate querying & reporting ; does NOT include ESP notifiable disease reporting MDPHnet Schema ESP Application Server MDPHnet Schema Optional email notification to Data Partner about new requests Optional email notification to requestor about responses

22. MDPHnet Query Tool Request Cycle: Data Partners querying data for their site(s) Data Partner 1 PMN DataMart Client 1 1. Data Partner user creates and submits query for local data analysis 2. The DataMart Administrator or Analyst at the site retrieves query 3. Sites review and run query against their local ESP database via the PMN DataMart Client 4. DataMart Administrator or Analyst reviews results 5. DataMart Administrator or Analyst returns results via secure network 6. Requestor from this Data Partner views results in PMN Portal -Users at Data Partners have options to receive query notifications throughout cycle 2 MDPHnet Query Tool Portal 3 4 6 5 Data Partner1 PMN DataMart EHR *Workflow includes local aggregate querying & reporting ; does NOT include ESP notifiable disease reporting ESP Application Server MDPHnet Schema

23. MDPHnet Data Flow* PopMedNet Query Tool (PMN), ESP Notifiable Disease Reporting MDPHnet Query Tool (PMN Portal) PMN DataMart Client Data Partner PMN queries: include custom queries for summary data as well as routine aggregate reporting queries (e.g. ILI) MDPH Staff: Query Requestor MDPH BID Notifiable Disease Case Reports MDPH PMN DataMart ESP Application Server Data Partner Staff: Query Requestor Data Partner EHR *Workflow includes aggregate querying & reporting as well as ESP notifiable disease reporting MDPHnet Schema ESP Data Model

24. FISMA Compliant Data Center MDPHnet Data Flow* PopMedNet Query Tool (PMN), ESP Case Reporting, TrimTracker (TT) & RiskScape (RS) MDPHnet Query Tool (PMN Portal) ESP.org Server TT/RS database PMN DataMart Client PMN DataMart Data Partner ESP Application Server ESP Common Data Model MDPHnet Schema RS/TT anonymized categorized patient level data TT/RS applications PMN queries are separate from RS/TT queries and user activity. Include custom queries as well as routine aggregate reporting queries (e.g. ILI) Only summary counts and averages are sent to the TT/RS application interface. The applications generate queries based on user selections Data updated weekly, patient level data with 1 row per patient with numbers to represent the values and variables. The site is also included. The data are anonymized, categorized and not identifiable. Data are sent from the sites to the ESPHealth.org server MDPH Staff MDPH BID MA Virtual Gateway Notifiable Disease Case Reports MDPH EHR ESP Common Data Model *Workflow includes aggregate querying & reporting, notifiable disease reporting, TrimTracker, and RiskScape