1. QDA 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. QDA – Business needs  On-Demand summaries are made by aggregating information (“building-blocks”) from different data- sources  Patient Summaries  Medication Lists  etc.  Different systems need different query methods -> Need for a profile that can take care of complex multi-query creation and result aggregation

3. QDA – Use Cases  On-Demand Medication Management  Prescriptions  Dispensations  Allergies interactions contra-indications  Relevant diagnoses  Relevant lab values  On-Demand Patient Summary  Derives building blocks from multiple sources  ‘Blue button’  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.

4. QDA – Query Dispatch and Aggregate  Generic tool 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. 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

6. 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

7. 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)

8. Register On-Demand Document Entry (ITI-61) XDS + ODD + QDA 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 Source QDA Content Source ITI-X: Create Multi-Source Summary Provide and Register Document Set (ITI-41) XDS XDS Retrieve Document Set XCA Query and Retrieve HL7 Care Record Query QED RESTful: FHIR, JSON, MHD Web Service ANSI SQL...? EHRPharmacyLaboratoryRadiologyPathology Intra- and Cross- community QDA Content Consumer QDA Content Consumer

9. Register On-Demand Document Entry (ITI-61) XDS + ODD + QDA + RECON 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 Source QDA Content Source Create Multi-Source Summary Provide and Register Document Set (ITI-41) RECON Share Content XDS XDS Retrieve Document Set XCA Query and Retrieve HL7 Care Record Query QED RESTful: FHIR, JSON, MHD Web Service XCF ANSI SQL...? EHRPharmacyLaboratoryRadiologyPathology Intra- and Cross- community

10. QDA parameters Report ID Patient ID Summaryformat Collate Reconcile From-datetime To-datetime ToFormat HL7 CDA HL7 V2 message HL7 V3 Message XML document Request Query ID Requestor ID (org. and person?) Patient 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 Target (institution) Required document template (OID) Query string (OID) Dispatch ‘Stitch’, collate to 1 doc Use RECON to reconciliate Message wrapper? Aggregate

11. Remarks  Some parts of the functionality can be covered by existing profiles. However, some functionality is missing:  Transforming documents / messages / webservices from different sources into one document  Receiving one report request, and then sendif a number of preformatted subqueries  Configurable subqueries  Add RECON / MCV / DEN / DSG etcetera to format and create the result-document  Content Creator

12. Remarks Profile or Whitepaper? o A lot of IHE profiles start as whitepaper o If there are “holes” in existing profiles, it would definitely warrant a profile o IHE/ITI: pure configuration management profiles often don’t make it through the first selection o Find synergy with DAF (recipe for existing problems) / RECON (aggregation) ? XCF is not the wholeanswer: o Is an optimization of XCA Query and Retrieve o It does not aggregate results into one document o Is not plug and play with ODD: there is no way to snapshot the results But it can be used as one of the ‘fetch’ options · Presentation o You might want to make the diagram/text more clear that you want to further profile/describe/specify the currently opaque ODD Document Source. This is probably not clear to people right now. QDA Content Source seems to be a separate actor interacting with a ODD Document Source. Maybe create a new diagram with just the new actors/transactions. Behavioral pattern

13. Remarks o How can a profile like qed / XCF know which subqueries it needs to perform to aggregate the summary? Behavioral pattern Activity diagram Synchronous and asynchronous queries Purposes  Can be called by ODD (On Demand Document) to create documents from multiple sources (including non-IHE) to create on-the fly actual information  Can be used by any Actor that needs a summary (view) from multiple existing documents

14. Suggestions?