Query HealthTechnical WG

3/8/2012

Agenda

Topic Time Slot

Administrative stuff and reminders 2:05 – 2:10 pm

RI Update 2:10 – 2:20 pm

HQMF to Java Script Update 2:20 – 2:35 pm

QRDA Specification UpdateQuery Envelope Update

2:35 – 3:00 pm

Administrative Reminders

• S&I Framework F2F • April 11 – 13th • Washington D.C • Query Health Activity stream

• Query Health Major Activities – Initial Thoughts• Code-a-thon • Specification reviews and finalization• Pilot activities

• Feedback/Thoughts on Agenda items to include …

RI Update

• RI Repository Link: http://code.google.com/p/query-health

• PopMedNet

• Working on reconciling the multiple code branches - created for HIMSS• Ensuring that all the required features for Query Health and other pilots are functional • Planning to work towards a release at the end of the month.

• i2B2• Design document done, going through internal i2B2 reviews.• Next Steps:

• Create a mapping of CEDD to the i2B2 Schema – directly useful to NY Pilot• Complete Translator work for HQMF • Integration of PopMedNet / i2B2

• hQuery • Working on reconciling multiple code branches – created for HIMSS • Work on completing the HQMF to Java Script translator

• Use of Value sets, • Execution of queries from i2B2 based on HQMF

• hQuery Integration with PopMedNet

• Translators• i2B2 XML to HQMF Translator from Keith Boone on the Repository• HQMF to Java Script Translator from Marc Hadley on the hQuery Repository

HQMF to Java Script Translator Update

• Marc Hadley to provide update

QRDA Updates

• QRDA• IG document in progress and hope to review soon.

• Draft posted: http://wiki.siframework.org/Query+Health+-+Results+Format

• Srinivas has represented NQF 59 results

• Posted on the Google Code Repository: http://code.google.com/p/query-health

• Update from Srinivas based on Review last week

QRDA Header QRDA Body

Reporting Parameters Section

MeasureSet Section Measure Section Measure Section

MeasureSet Section Measure Section Measure Section

Measure Section Measure Section

QRDA Header QRDA Body

– Reporting Parameters Section

– Measure Section

Edits to QRDA Cat-III structure

As per draft standard

7

For Query Health

CONF-QRDA-III-20: A QRDA Category III report SHALL contain at least one and MAY contain more than one Measure Set section containing information about the measure set.

CONF-QRDA-III-20: A QRDA Category III report MAY contain one or more Measure Set sections containing information about the measure sets.

Edits to QRDA Cat-III draft standard

As per draft standard

8

For Query Health

Rationale: The HQMF query addresses only a single measure, not a Measure Set, so it is recommended to make Measure Sets optional in the response.

CONF-QRDA-III-21: A QRDA Category III report SHALL contain at least one and MAY contain more than one Measure section, each containing information about a single measure.

CONF-QRDA-III-21: A QRDA Category III report SHALL contain exactly one Measure section, containing information about a single measure.

Edits to QRDA Cat-III draft standard (contd.)

As per draft standard

9

For Query Health

Rationale: The HQMF query addresses only a single measure, so it is recommended to remove results for multiple measures in the response. However a Query envelope may contain multiple QRDA cat-III responses

Using business names …

In HQMF standard, it is recommended to go for business names as HQMF uses section, entry, and sourceOf in many places. The rationale is that the semantics of these items are expressed in code, @typeCode, etc., in the XML and this makes the XML difficult for readers to understand. But in my opinion, this XML is meant for computers, not for humans.

Also in QRDA cat-III response, unlike HQMF, one can’t find so many sections, entries etc.

Further unlike HQMF, the QRDA Cat-III is built on top of HL7 CDA and is a peer to HL7 CCD, which is more widely used

Recommendation: Do not use business names in QRDA cat-III

10

Using CLASSIFIERS …

In HQMF standard proposed edits, there is a mention of CLASSIFIERS to enable Measure (Query) results to be broken down by population subgroups: e.g., age range, gender, race/ethnicity. But this may call for addition of another new SECTION in HQMF other than Data Criteria and Population Criteria; which is I don’t see in that proposal.

However CLASSIFIERS are supported by the way of “measure-specific grouping data elements” of Measure Section in the QRDA Cat-III response

11

Referencing HQMF query in QRDA Cat-III

Need: QRDA Cat-III response needs to contain the reference to HQMF query that is being used to create this response

Recommendation: Use the “relatedDocument” element in QRDA Header to capture the HQMF query information in the QRDA cat-III response (though the original intent of relatedDocument is to connect the parent document and it’s child document. However here it is being used to connect a query and it’s response)

<relatedDocument typeCode='XFRM'>

<parentDocument>

<!-- HQMF Query ID -- >

<id root="2.16.840.1.113883.3.1619.5148.3.20120214.165226983.1"/>

</parentDocument>

</relatedDocument>

12

Query Envelope Updates

• Two separate discussions

• Around elements from DS4P and XD* from DIRECT to enhance the envelope

• Security Risk Analysis of the Query Envelope

• John Moehrke from GE Healthcare facilitated the session

• Followed the same process as HL7 / IHE

• Link to Materials: http://healthcaresecprivacy.blogspot.com/2010/02/how-to-write-secure-interoperability.html

• Spreadsheet attached to Query Envelope Page: http://wiki.siframework.org/Query+Health+-+Query+Envelope

• Provide feedback on additional risks that need to be considered.

• Follow up session on Friday 3/9/2011 at 1pm EST

Query Envelope Risk Analysis

GoTo Meeting Information: Friday 3/9/2012 (1pm – 2pm EST)

https://www3.gotomeeting.com/join/968603950 2. Use your microphone and speakers (VoIP) - a headset is recommended. Or, call in using your telephone. Dial +1 (404) 891-0552Access Code: 968-603-950Audio PIN: Shown after joining the meeting Meeting ID: 968-603-950 GoToMeeting® Online Meetings Made Easy™

Specification Updates

• HQMF • IG document in progress and hope to review soon.

• Draft posted: http://wiki.siframework.org/Query+Health+-+Query+Format • Query Catalog for sample query representation and validation posted on wiki

• Draft posted: http://wiki.siframework.org/Query+Health+-+Query+Format • Need volunteers to fill this out, one query at a time.

• CEDD• Draft Specification posted:• http://wiki.siframework.org/Query+Health+Clinical+Element+Data+Dictionary+%

28CEDD%29

Next Steps

• Specification Reviews• Review Query Envelope Risk Analysis and provide feedback• Feedback on QRDA activity.

• Specification Usage• Volunteers needed to represent Sample Queries using revised HQMF models and

schemas.

• Volunteers requiring access to the code repository• Please sign up for a google account at http://code.google.com• Project Repository - http://code.google.com/p/query-health/ • Sign up for the RI at http://

wiki.siframework.org/Query+Health+Reference+Implementation