Data Access Framework (DAF) All Hands Community Meeting November 20th, 2013.
Data Access Framework (DAF) S&I Initiative Update June 19 th, 2014 1.
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Transcript of Data Access Framework (DAF) S&I Initiative Update June 19 th, 2014 1.
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Data Access Framework (DAF)
S&I Initiative Update
June 19th, 2014
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Overview (Recap)
• BlueButton initiatives enabled patients to access to their own data
• DAF is similar, except it is focused on enabling providers to access their patient’s data using modular and substitutable standards– Within their own Local Organization (Local DAF)– From another Targeted Organization (Targeted DAF)– Between multiple Organizations (Federated DAF – Future
phases)
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Challenges to Address
Data Access Complexities include:
– Ability to access data within and across organizations using standards
– Ability to access patient’s data using document metadata paradigm• Get latest Lab Report for a Patient so that I can check her HBA1C
levels• Get CCD’s for the last 3 years for a patient• Get the last History and Physical Note for the patient
– Ability to access patient’s data based on discrete data elements captured within a patient record
• Get latest lab report for a patient where HBA1C > 7%• Get me all patients < 5 years who are due for an immunization• Get me all patients > 75 years with HBA1C > 7%
– Enable both Patient level (Local and Targeted ) and Population level data (Data about multiple patients – only for Local)
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Out Of Scope
DAF does not address the following:– Trust establishment between organizations for Targeted Query
• Could leverage all the trust work happening in Direct
– Discovery of End Points for Targeted Query
– Patient Matching rules and algorithms that organizations may implement
– Policies that allow/dis-allow disclosure of patient data
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Current State
• S&I/IHE PCC DAF White Paper– Describes how to use existing IHE profiles to meet DAF needs and identifies
gaps that need to be filled (Both new profiles and change proposals)– Gaps being prioritized to inform upcoming IHE Planning Cycle.– Currently under Public Comment period http://www.ihe.net/Public_Comment/#
pcc• S&I Document Metadata Based Access Work Group
– Allows ability to access patient data using document metadata paradigm– Finished Candidate standards analysis– Creating an Implementation Guide around the standards
• S&I Data Element Based Access Work Group– Currently performing standards analysis – Completed FHIR, working on others identified by the community (HL7v2, QED,
HQMF etc)• S&I DAF Direct Transport WG (Community/Volunteer driven WG)
– Working on a solution using all the content models from Document and Data Element Based Access Work Groups but changing the Transport from SOAP/HTTP to Direct/SMTP.
Create IG based on existing standards
WP Comment
Period
Notional Project Timeline S&I Lifecycle
(Discovery Pilot & Evaluation)
August November
September
October December
DAF/IHE White Paper Published
July
Implementation (DAF/IHE
Community)
DAF IHE/ S&I Joint Work GroupIH
E A
cti
vit
ies
Document IG
Consensus
Implementation (S&I Community)
Implementation (S&I Community)
TW
G 1
: D
ocu
men
t M
eta
data
b
ased
access
for
LD
AF &
TD
AF
Candidate Standards Analysis
Finalize Actors + Transactions +
Technology Stacks and Standards
TW
G 2
: D
ata
Ele
men
t b
ased
access f
or
LD
AF &
TD
AF
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
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IHE/S&I Joint White Paper
Data Access Behavior Model
Network Transport
Implementable Information
Model
IHE Profile
Patient Population
Patient Demographics
Request/Response MLLP HL7 V2 ADT PIX/PDQ
Gap1
SOAP HL7 V3 Patient Administration
PIX/PDQ V3 XCPD (Federated)
REST FHIR Patient PDQM
Publish/Subscribe SOAP HL7 V3 Patient Administration Gap2
REST FHIR Patient
Encounter Documents and Metadata
Request/Response SOAP ebXML RIM+CDA XDS/XCA MPQ
REST FHIR+CDA MHD Gap3
SMTP Gap10
Publish/Subscribe SOAP ebXML RIM+CDA DSUB Gap4
REST FHIR+CDA Gap5
SMTP Gap11
Detailed Clinical Data
Request/Response SOAP HL7 V3 Care Record QED8 Gap6
REST FHIR Gap7
Publish/Subscribe SOAP HL7 V3 Care Record CM9
REST FHIR Gap7
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Document Metadata Based Access Overview
Query Requestor
Query Responder
Query
Query Results
Query Stacks Required• SOAP and RESTful
Query Stacks Required• SOAP or RESTful
DAF QueriesFind Document(s) based on Patient IdentifiersFind Document(s) based on Patient DemographicsGet Document(s) based on Patient Identifiers Get Document(s) based on Patient DemographicsGet Document(s) based on Document IdentifiersGet Document(s) for multiple patients based on patient identifiersFind Patient Identifiers based on Patient Demographics
Find Patient Demographics based on Patient Identifiers
DAF Supporting CapabilitiesProvide message integrity and confidentiality of queries and results exchanged between the Query Requestor and the Query Responder
Ability to provide user and system identities as necessary for authentication and authorizationAbility to tag the queries and the query results with security metadata that will enable policy enforcement for query execution and data disclosure
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Document Metadata Based Access Query Stacks
Query Stack Component SOAP Query Stack RESTful Query Stack
Transport Protocols HTTP HTTP
Message Packaging Envelope SOAP 1.2 HTTP Message Structure
Message Integrity TLS TLS
Confidentiality TLS TLS
System Authentication Mutual TLS Mutual TLS
Access Controls/Authorization * XUA (Targeted only) * IHE IUA (Based on OAuth2) + FHIR Tags *
Consent and Security metadata * DS4P + XDS Metadata (Targeted only) * DS4P + FHIR Tags *
Auditing ATNA ATNA + FHIR Security Event
Query Structure XCA, XCPD – Patient LevelMPQ – Population Level
IHE MHD v2 (Being Aligned to FHIR Document Resources) **
Result Structure CCDA CCDA expressed via FHIR Document Resources
API’s XCA/XCPD/MPQ WSDL IHE MHD v2 **
* - Specifying profiles for Targeted DAF only, Local DAF choices left to the organization** - IHE working on finalizing IHE MHDv2 which aligns with FHIR this summer – DAF will reanalyze once it is published
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Data Element Based Access
Query Requestor
Query Responder
Query
Query Results
Query Stacks Required• Under Analysis
• FHIR - Initial Analysis performed
Query Stacks Required• Under Analysis
• FHIR - Initial Analysis performed
• Data Elements for Constructing Queries and Query Results
• Started from MU Stage 2 ToC/VDT data elements + community input
• Current Data Element Spreadsheet
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Data Element Based Access(Potential FHIR Query Stack)
Query Stack Component RESTful Query Stack
Transport Protocols HTTP
Message Packaging Envelope HTTP Message Structure
Message Integrity TLS
Confidentiality TLS
System Authentication Mutual TLS
Access Controls/Authorization * IHE IUA (Based on OAuth2) + FHIR Tags
Consent and Security metadata * DS4P + FHIR Tags
Auditing ATNA + FHIR Security Event
Query Structure FHIR Queries based on RESTful resources (FHIR Query Resource May be used along with resources)
Result Structure FHIR Resources
API’s FHIR API’s
Note: Query Stack Components for Document Metadata based Access and Data Element based Access share same components except for Query Structure and Query Results.
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Questions
Useful Links• DAF Homepage
– http://wiki.siframework.org/Data+Access+Framework+Homepage• DAF Initiative Signup
– http://wiki.siframework.org/Data+Access+Framework+Join+the+Initiative• DAF Charter
– http://wiki.siframework.org/Data+Access+Framework+Charter+and+Members• DAF Standards, Harmonization and Implementation Activities
– http://wiki.siframework.org/DAF+Standards+Harmonization+and+Implementation
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Initiative Support Leads• For questions, please feel free to contact your support leads:
– Initiative Coordinator: John Feikema [email protected]– ONC Sponsors: Mera Choi [email protected]– Support Team:
• Project Management: – Gayathri Jayawardena [email protected]
• Technical Support: – Dragon (Nagesh) Bashyam [email protected]
• Standards SME:– Ed Larsen [email protected]
• Standards Support: – Angelique Cortez [email protected]
• Vocabulary and Terminology Subject Matter Expert: – Mark Roche, MD [email protected]
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