Data Access Framework (DAF) S&I Initiative Update

1. Data Access Framework (DAF)S&I Initiative Update June 19th, 2014

2. 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)

3. 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)

4. 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

5. 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 periodhttp://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.

6. Notional Project Timeline S&I Lifecycle (Discovery  Pilot & Evaluation) July August September October November December DAF/IHE White Paper Published Data Element IG Consensus Document IG Consensus Implementation (DAF/IHE Community) IHE Activities WP Comment Period DAF IHE/ S&I Joint Work Group Implementation (S&I Community) Pilots & Testing TWG 1: Document Metadata based access for LDAF & TDAF Create IGbased on existing standards Creating Operation Plan for Pilot Testing Pilots and Testing Balloting Activities Pilots & Testing Implementation (S&I Community) TWG 2: Data Element based access for LDAF & TDAF Candidate Standards Analysis Finalize Actors + Transactions + Technology Stacks and Standards Create IG Creating Operation Plan for Pilot Testing Pilots and Testing Balloting Activities

7. IHE/S&I Joint White Paper

8. Document Metadata Based Access Overview Query Query Requestor Query Responder Query Results • Query Stacks Required • SOAP or RESTful • Query Stacks Required • SOAP and RESTful

9. Document Metadata Based Access Query Stacks * - 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

10. Data Element Based Access Query Query Requestor Query Responder 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

11. Data Element Based Access(Potential FHIR Query Stack) Note: Query Stack Components for Document Metadata based Access and Data Element based Access share same components except for Query Structure and Query Results.

12. Questions

13. 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

14. Initiative Support Leads • For questions, please feel free to contact your support leads: • Initiative Coordinator: John Feikemajohn.feikema@siframework.org • ONC Sponsors: Mera Choi mera.choi@hhs.gov • Support Team: • Project Management: • GayathriJayawardenagayathri.jayawardena@esacinc.com • Technical Support: • Dragon (Nagesh) Bashyamnagesh.bashyam@drajer.com • Standards SME: • Ed Larsen ed_larsen@comcast.net • Standards Support: • Angelique Cortez angelique.j.cortez@accenture.com • Vocabulary and Terminology Subject Matter Expert: • Mark Roche, MD mrochemd@gmail.com