Query Health Distributed Population Queries Implementation Group Meeting

1. Query Health Distributed Population QueriesImplementation Group Meeting December 20, 2011

2. Agenda • Where we are going • Weekly Summary • Clinical • Operations • Technical • Important Announcements • Open Discussion / Next Steps

3. Query HealthWhere We are

4. Query Health Meeting Time Reminders Implementation Group Tuesdays 1:30pm-3:00pm EDT Clinical Working Group Wednesdays 12pm-1pm EDT Clinical Concept Mapping Sub-Working Group Tuesday 3pm-4pm EDT Operations Working Group Thursdays 11am-12pm EDT Pilots Sub-Working Group Thursdays 3:30pm-4:30pm EDT Technical Working Group Thursday 2pm-3 pm EDT Sign Up at QueryHealth.org Download to your calendar at QueryHealth.org

5. Action Items

6. Clinical Working Group December 20, 2011

7. Concept to Codes • Meetings will occur every Tuesday from 3:00 – 4:00 PM EST • On January 3rd , 10th , and potentially 17th the meeting time will be extended to 2:30-4:00pm to provide ample presentation time for our SMEs • 12/13 Meeting Summary • Presentations from Andy Gregorowicz (hQuery) and Shawn Murphy (i2B2/SHRINE) • Reviewed Questions for Considerations and Proposed Outline for end deliverable to help frame the presentations and the end deliverable summarizing presented standards, tools, and frameworks • Next Steps • 12/20 – Continue presentations from our SMEs • (Shawn Murphy (Cont. from this week), Stan Huff, Rick Biehl, and Oliver Bodenreider). Full schedule can be found here • 12/27 - No Meeting • 1/4 and 1/10 - Additional presentation schedules being confirmed

8. Query Health CEDD Timeline

9. This Week’s Plan for the Query Health CEDD • Query Health CEDD Crosswalk available for community input: http://wiki.siframework.org/Clinical+Information+Model+Activity • Volunteers working through key sections of the crosswalk (THANK YOU!) • Crosswalk available at the following URL: https://docs.google.com/spreadsheet/ccc?key=0ApW4Ox66ml2IdEtYR0lwenlJVWl6RC1vVnZuaEppeWc • Crosswalk updated with hQuery and SHRINE mappings, and additional clinically-focused notes from volunteers • Our approach for this week: • Finalize data definitions • Define examples for specific elements • Final crosswalk review • Support team to begin developing supporting documentation (for review in first week of January)

10. Operations Working Group December 20, 2011

11. Key Topics Covered/Discussed • Discussed adding the following changes to the Draft Query Health Data Use Agreement: • Language to explain what happens to data once an agreement is terminated • Indemnity clause • Definitions or HIPPA references to certain terms • Giving the right to terminate the agreement to both the Data Source and the Query Source • Purpose statement

12. Operations Workgroup Next Steps • Review second draft of Query Health DUA

13. Pilots SWG Meeting update • Regular SWG meeting held on Thursday 12/15 • 8 attendees, excluding ONC staff.  • Discussed three pilot projects: NYC/PCIP, NYS, Azzly • ONC Support offered assistance to SWG attendees in completing pilot project profiles.

14. New York City DHM Pilot • Received and reviewed preliminary PCIP pilot project profile from the New York City Department of Health and Mental Hygiene. • Dr. Mark Buck submitted, but was unable to attend the meeting. • Primary Care Information Project (PCIP) would run the pilot. • The NYCDHMH already has a distributed query network built on eClinicalWorks (“the Hub”). • The pilot would be self-sufficient as to partners, development resources, etc.

15. New York State DoH Pilot • The New York State Department of Health stated its intention to prepare a pilot project profile very shortly. • Dr. Linh Le, Director of Informatics, Bureau of Healthcom Network Systems Management is taking the lead. • Dr. Le and colleagues are discussing the particulars of their proposal and will initiate a pilot project profile soon.

16. Azzly Pilot • Azzly is a Web-based EHR vendor and provider with a number of clients. • Mr. Jeff Ice, Azzly CTO, stated his intention to complete a pilot project profile shortly. • The pilot would run in a test environment using test data that Azzly has already developed for training purposes. • Azzly would adapt their software to conform to the Query Health requirements. • Azzly would offer the distributed query network software as a service to its clients after the pilot project.

17. Pilot Outreach • Approached the Kentucky HIE to solicit interest in a pilot project; no response yet. • Approached Dr. Michael Klompas of the Harvard Pilgrim Health Care Institute regarding his interest in conducting a pilot.  Dr. Klompas is on vacation, so no response yet. • Met with Dr. AneelAdvani, Associate Director for Medical Informatics at the Indian Health Service, to discuss IHS conducting a pilot project.  Dr. Advani was optimistic that he’d be able to do so, and that discussion will continue. • Completed initial list of organizations and people to be contacted to solicit pilot project participation, merging information from the initial list of 2 to 3 months ago, recent contacts from the SWG, and personal contacts from the support team.

18. Technical Working Group December 20, 2011

19. Technical Approach Consensus Update • Technical Approach document. • Directional document detailing the decisions made so far in the Technical WG with respect to specifications, standards and the Reference Implementation • Approach documents the activities that will be pursued by the Technical WG to create specifications, standards and the Reference Implementation • Call for Consensus on the Technical Approach Completed • http://wiki.siframework.org/Query+Health+Technical+Approach • http://wiki.siframework.org/Query+Health+Technical+Approach+-+Consensus+Page • Two “No” Votes to be resolved by updating the wording, no change in direction. This is not yet done, but the coordination to resolve this is ongoing.

20. Vendor Advisory Meeting Update • EMR and HIE Vendors Advisory Meeting • Purpose: To get feedback on best way to integrate with the data sources and provide them an update on Query Health • Summary: • Vendors expressed their driving force to be their customers and regulation but definitely validated the technical approach and see value in using it • Data Warehouses and external data marts are definitely encouraging • Data Content • Focus on the C32 element sub-sets which are more widely implemented across EMR vendors as reliable data quality mechanisms • C32 / CCD’s are the ones which are most widely available across implementations • Data for all sections is not all structured, so the data analysis with different C32/CCD’s is important • Vocabularies and Code Sets: • Alignment with MU Stage 1 and Stage 2 will help a lot as we go forward • Vendors have not implemented standard code sets for many reasons • Concept to Code Mapping • Use and Leverage ontology capabilities such as i2B2 • Local mappings will be essential

21. TWG Activities Moving Forward • Reference Implementation • Wiki’s for Reference Implementation up and running • http://wiki.siframework.org/Query+Health+Reference+Implementation • Google Code Repository created • Specifications and Standards • Wiki for Specification and Standards created • http://wiki.siframework.org/Query+Health+Specifications+and+Standards

22. Reference Implementation Code Repository Contents • Code Repository will have only the source code that will be written to enhance and integrate the existing reference implementations • In other words PopMedNet, hQuery, and i2B2 will reside in their current locations • Plug-In Code that will be required for their integration for the purposes of Query Health will be added to the Query Health Code Repository • Will Contain test data and other data samples like C32 • Architecture and Design Documents relevant to the Query Health and its components

23. Reference Implementation Code Repository Structure • Query Health Root • /src • PopMedNet • Binaries • Hquery • Binaries • Libraries • Plug-ins • Standards Translators • i2B2 • Binaries • Libraries • Plug-ins • Standards Translators • /Reference Data Sources • C32 Samples • /Reference Queries • MU Queries

24. Reference Implementation Tasks

25. Reference Implementation Tasks Cont’d

26. Envelope Specification Tasks

27. Query Format Specification Tasks

28. Query Format - Activities Update • Met with Keith Boone / Marc Hadley to discuss activities to focus on developing the next version of HQMF • Greening HQMF is a priority • Identifying Expressions for Measure Logic as the first starting step • Create appropriate classes in the model to represent key concepts • Keith presented initial concepts to HL7 SDWG • HL7 interested in getting involved to understand the changes • Initial discussions with NQF started • NQF looking forward to get involved, determining the best approach to get them involved • Continuing discussions with the various stakeholders – followup meeting to discuss options

29. Results Format Specification Tasks

30. CEDD Specification Tasks

31. Next Steps • Reference Implementation work stream • Volunteer to register for the reference implementation work. • http://wiki.siframework.org/Query+Health+Reference+Implementation • Specifications and Standards documentation work stream • Proof of Concepts will continue on the Reference Implementation work stream • Volunteer to take the lead in documenting the specifications and standards • http://wiki.siframework.org/Query+Health+Specifications+and+Standards

32. Important Announcements • Enjoy the holidays! • Meetings cancelled next week unless otherwise noted: • NOTE: Clinical Concept Mapping SWG will be MEETING!