Data Access Framework All Hands Community Meeting July 2, 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 General Announcements5 minutes Presentation by the Clinical Quality Framework (CQF) Team on QUICK (Quality Improvement Clinical and Knowledge model) 50 minutes Next Steps/Questions5 minutes 3

4 General Announcements DAF IHE/S&I Joint WG – This workgroup will be meeting every other week Upcoming schedule: – Monday, July 7 th at 10:00 am (EDT) – The week of July 21 st will be the IHE Trial Implementation Meeting. Meeting details will be posted on the DAF wiki as soon as it is released – White Paper comment period ends tomorrow White Paper: Comment Form:

Create IG based on existing standards WP Comme nt Period Notional Project Timeline S&I Lifecycle (Discovery  Pilot & Evaluation) Today 7/2 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 Implementation Meeting TWG 1: Document Metadata based access for LDAF & TDAF

6 Data Elements Comment Form Take a moment to review the latest DAF data elements spreadsheet and submit your comments through the online comment form: mentation mentation

Overview of QUICK CQF team discussion with DAF team 2 nd July 2014

QUICK Quality Improvement Clinical and Knowledge model QUICK = Harmonization of vMR and QDM with mappings to FHIR Domain of QUICK is to model patient data 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

Timeline Project formally initiated in Fall 2013 QIDAM = Conceptual model Ballot passed in May 2014 Moving towards publication in August 2014 QUICK = Logical model Comment only ballot in September 2014 FHIR mappings in Jan 2015

Overview of class model in QIDAM Walk through of UML model Salient features Core: Clinical Statement Topic: Actions and Observables Actions: Modality and Act

What will QUICK class model add? FHIR datatypes Extension mechanism Concrete statement types E.g., ProcedureOrderOccurrence The exact structure of how this statement is constructed in QUICK is being determined

Mapping to FHIR Objectives Interoperability Gain physical format, API Initial analysis of QIDAM-FHIR mapping was performed We expect that to create mappings to FHIR, we will Create new FHIR resources, e.g., Prognosis Profile existing resources, e.g., DiagnosticOrder Tweak QUICK classes

An example: QUICK and CQL Retrieve “Inpatient” encounters performed that have a condition of “Acute Pharyngitis” that began during the encounter and continues after it. Only include encounters with a duration of 120 days or more. For each encounter, return a tuple with the id and the length of stay. Order the results by the length of stay descending. CQL complements FHIR and does not replace it. 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.

DAF perspective Does it address the data elements that is part of the DAF data element spreadsheet (attached) See responses in spreadsheet Does QUICK have a query syntax as part of the specification? If so, how does it compare to FHIR’s query syntax ? Yes, CQL + QUICK. But we rely on FHIR or other specs for implementation. Does it have any specific transport requirements? No. See FHIR Does QUICK have any packaging specification ? (for e.g some kind of a XML container to package the elements) No. See FHIR How can the model be used to extract data elements (For e.g., we would like to query for meds, problems, allergies etc) See example, CQL + QUICK

DAF perspective What is the real world adoption of the standard ? TBD. Based on QDM and vMR which have been adopted in their respective domains What are the strengths of the model? Tuned for reasoning about clinical concepts Where do you see the model going in terms of next steps? Balloting logical model and FHIR mapping What is the level of support for security/provenance metadata ? No security metadata – out of scope for QUICK Some provenance metadata in ClinicalStatement

Questions 16

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 18