1. Multi Query Dispatch and Aggregate MQDA Work Item Proposal February 10-14 th, Vienna IHE F2F meeting Vincent van Pelt, Albert-Jan Spruyt (Nictiz) Mark Sinke, Walco van Loon (ForCare)

2. Business needs  Healthcare professionals need up-to-date summaries containing the most current medical information about the patient  These summaries are made by aggregating information (“building blocks”) from different sources that each generate a different part of the information  These different systems use different query methods  The information from these systems may be created on the fly (from their database), or they can be already existing documents  The information building blocks coming from different systems need to be aggregated into one summary -> Need for a profile that can take care of complex multi-query creation and result aggregation

3. Use Cases  On-Demand Medication Overview  Prescriptions  Dispensations  Allergies, contra-indications  Relevant diagnoses  Relevant lab values  On-Demand Patient Summary  Derives building blocks from multiple systems  ‘Blue button’ creation?  On-Demand Emergency Care Summary  Combined information from emergency call center, ambulance, Emergency department, ICU  On-Demand Integrated Care Overview  Combined information from PCP, dietician, physiotherapist, laboratory, etc.  On-Demand Laboratory List  Aggregated overview of laboratory results from different dates and locations

4. MQDA Multi Query Distribute and Aggregate Generic profile for the on-demand creation of multi-source summaries and aggregated reports Process : 1. One report request 2. Multiple queries to several data-sources 3. Processing and aggregation 4. One report result

5. Functionalities Report request: MedSumm 1 Report ID Query ID Query Method Target OIDResult Template OID Query parameters MedSumm 1MedPrescrHL7 Query PCP APRE… MedSumm 1MedPrescrHL7 Query Hospital BPRE… MedSumm 1MedDispHL7 V2Pharmacy XDIS… MedSumm 1MedLabDataQEDLaboratory YLAB-x… MedSumm 1MedDiagDataXDSEMR-Hospital ZDIAG-x… PatientSumm 1DiagData………… PatientSumm 1LabData………… Query result 1 Query result 2 Query results.... Report result: MedSumm 1 Aggregation

6. XDS Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer

7. Register On-Demand Document Entry (ITI-61) XDS + ODD Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer On-Demand Document Source On-Demand Document Source

8. Register On-Demand Document Entry (ITI-61) XDS + ODD (+ persistent storage) Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer On-Demand Document Source On-Demand Document Source Provide and Register Document Set (ITI-41)

9. Register On-Demand Document Entry (ITI-61) XDS + ODD + ? Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer On-Demand Document Source On-Demand Document Source Provide and Register Document Set (ITI-41) Not defined how this profile creates the on-demand document

10. Register On-Demand Document Entry (ITI-61) MQDA Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer On-Demand Document Source On-Demand Document Source MQDA Content Creator MQDA Content Creator ITI-X: Create Multi-Source Summary Provide and Register Document Set (ITI-41)

11. Register On-Demand Document Entry (ITI-61) MQDA Provide and Register Document Set (ITI-41) Retrieve Document Set (ITI-43) Register Document Set (ITI-42) Registry Stored Query (ITI-18) Document Registry Document Registry Document Source Document Source Document Repository Document Repository Document Consumer Document Consumer On-Demand Document Source On-Demand Document Source QDA Content Creator QDA Content Creator ITI-X: Create Multi-Source Summary Provide and Register Document Set (ITI-41) HL7 Care Record Query QED RESTful: FHIR, JSON, MHD Web Service XDS Retrieve Document Set XCA Query and Retrieve XCF ANSI SQL... EHRPharmacyLaboratoryRadiologyPathology Intra- and Cross- enterprise Nursing

12. Deploying existing profiles (Query Distributor) QED RESTful: FHIR, JSON Web service HL7 V2 Query HL7 CR Query ANSI SQL... Content Creator (Query Aggregator) RECON DSG MCV... DEN 1. One report request 2. Multiple queries 3. Processing 1. One report result ITI – X Create Multi-Source Summary

13. QDA parameters Report ID Requestor ID Patient ID Summaryformat Collate Reconcile From-datetime To-datetime ToFormat HL7 CDA HL7 V2 message HL7 V3 Message XML document Request Report ID Requestor ID Patient ID Query ID Target ID Query Method XDS Retrieve Document Set XCA Query and Retrieve HL7 Care Record Query QED RESTful: FHIR, JSON, MHD Web Service ANSI SQL...? Query string (OID) Required document template (OID) Distribute ‘Stitch’, collate to 1 doc Use RECON to reconciliate Message wrapper? Aggregate

14. Remarks  Some parts of the functionality can be covered by existing profiles. However, some functionality is missing:  Receiving one report request, and then sending a number of preconfigured subqueries  Configuration of multi-source query summaries  Transforming information from different sources into one document  It is a recognizable profile that solves a real-world demand  Find synergy with RECON, DAF, MCV

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