Query Health Distributed Population Queries Implementation Group Meeting

1. Query Health Distributed Population QueriesImplementation Group Meeting September 27, 2011

2. Participation Instructions for WebEx Select the “Q&A” button in the WebEx toolbar. Select “All Panelists” in the Q&A box. Type your question and hit send. We’ll call on you to state your comment / question . • Please Note: • This session will be recorded • Lines are open so please mute your line to avoid “Music on Hold”

3. Agenda • Summary of Last Meeting & Reminders • WG updates • Clinical • Technical • Business • Charter – 2nd Call for consensus • Discussion Forums • Security / Privacy Tiger Team – Recap • Meaningful Use Working Group • Open discussion / Next Steps

4. Query HealthScope and Approach HIT Policy Committee: Policy Guideposts Practice drives standards Rough consensus Running code (open source) Pilot Specifications Standards

5. Query HealthWhere We are

6. Query HealthCalendar Implementation Group Tuesdays 1:30pm-3:00pm EDT Technical Work Group Wednesdays 11am-12pm EDT Clinical Work Group Wednesdays 12pm-1pm EDT Business Work Group Thursdays 11am-12pm EDT First Face to Face Meeting October 18-19 Sign Up at QueryHealth.org Download to your calendar at QueryHealth.org

7. Query HealthWho’s participating (As of 9/27) 95+ Participating Organizations • Public Health Agencies • Health IT Vendors • Health Information Exchanges • Academic Partners • Health Systems • Patient Advocacy Organizations

8. Recap of Last Meeting • Reviewed Query Health Scope, Approach, Timeline, and Organization • Reviewed the objectives of each working group • Clinical – Use Cases, User Stories, Clinical Information Models • Technical – Architectural principles, technical standards / specifications, design of pilot implementations • Business – best practices for privacy, data use, network partner coordination • Discussed Policy Sandbox and presentation to HITPC

9. Action Items

10. Clinical Working Group Update from 9/21 Meeting

11. Key Topics Covered/Discussed • Presented & Discussed Community User Story proposals • Expanded Analysis User Story (Presented by Kim Nolen & Lindsey Hoggle) • Updated Generic Population Measures User Story (Presented by Michael Buck) • Recap: Proposed User Stories

12. Key Decisions & Next Steps Decisions • The Working Group members decided it would be best to have the Generic User Story be included as part of the Use Case supplemented by 1-2 additional User Stories.  Work Assignments/Next Steps • Develop, refine and provide comments using the wiki discussion tab for the following: • Proposed User Stories • Example User Story – Case Control, Vaccine Efficacy • Example User Story – Case Control, Statin Efficacy • Generic Population Measures User Story • Consumer Perspective User Story • Expanded Analysis User Story • All Hazards User Story • Hypothesis Generation User Story • Sentinel user story • The Working Group will prioritize and select the remaining 1-2 User Stories during the 9/28 meeting based on; • National Priorities • Leveraging existing research and public health network infrastructure • Review and comment on draft Functional Requirements

13. Query HealthTechnical WG Update9/27/2011

14. Technical WG Update • Two major discussion topics • Abstract Model discussion - Sean Nolan • Scan of Existing standards discussion – SrinivasVelamuri

15. Abstract Model Discussion

16. Query Network Community of participants that agree to interact with each other. There will be many networks; requestors and responders may participate in multiple networks. Query Authorized Requestors Participating Responders

17. Query Lifecycle Authorized Requestor 1 7 Aggregator Composer 6 • Requestor optionally uses a composer to create a query and submits it to their dedicated agent. • Agent submits the query over the Internet to each participating responder’s gatewayand awaits responses. • At each participating responder, the standard gateway passes the request to a site-specific adapter. • The adapter calculates site results for their site and returns them to the gateway. • The gateway returns site results to the appropriate agent. • The agent returns site results to the aggregator that combines site results into combined results • The aggregator makes interim and final results available to the requestor. Agent 2 5 Gateway Gateway 4 3 Adapter Adapter Clinical Data Clinical Data Responder “1” Responder “N” …

18. Query Envelope Query Response Responder identifier Response identifier (unique within responder space) Requestor identifier Query identifier Freeform notes for requestors (List of) Response Items Item name/tag Item status Item response payload • Requestor identifier • Query identifier (unique within requestor space) • Freeform notes for responders • Query type and version • (List of) Query Items • Item name/tag (unique within request) • Item request payload

19. Query Payload • Query Health supports multiple “query types” traveling over the same transport and envelope • Types are identified by a name and version • E.g., “MU Stage 1 EP/1.0” • Each type implies • Query syntax • Clinical information model • Response format

20. Existing Standards Discussion

21. Update from Discussions • Standards Examined • QRDA • QRDA Category I – Single Patient Quality Report • QRDA Category II – Multi-Patient Quality Report • QRDA Category III – Aggregate or Summary Level Quality Report • HQMF or eMeasures – Health Quality Measures represented in Electronic Format • To determine if either of these two standards can be used to represent Queries and/or Results Payload

22. Summary of QRDA and HQMF • Summary from the WG Discussion: • Query Health will have to support different types of queries including dynamic queries and a variety of result formats • Given the generic use cases and purposes that Query Health standards and protocols will be used for, the WG thinks that QRDA and HQMF are too constrained as they currently exist.

23. Technical WG – Next Steps • Will be working towards WG approval of the Abstract model and bring it to the Implementation Group • Sign up for developing and refining the various artifacts at the following links and present at the next WG meeting: • Abstract Model Discussion Link - http://wiki.siframework.org/Query+Health+Abstract+Model+and+Terminology • Patterns Summary Discussion Link - http://wiki.siframework.org/Summer+Concert+Series+Patterns+and+Summary • Existing Standards Discussion Link - http://wiki.siframework.org/Query+Health+-+Existing+Standards+and+Models+Landscape

24. QRDA Category I Sample

25. QRDA Category II Sample

26. QRDA Category III Sample

27. HQMF Sample

28. HQMF Sample Cont’d

29. Business Working Group Update from 9/22 Meeting

30. Key Topics Covered/Discussed • Points of Discussion • Use key secondary uses for domain specific requirements – these have been added to Matrix • Examine privacy and security framework developed for caBIG in work with the University of Michigan • Clarification of plans for pilot(s) and use of Policy Sandbox • ONC supported pilots will use the Policy Sandbox • Different applications of Query Health tools will conform to the necessary data use agreements and privacy and security regulations as applied to the specific query domain and type

31. Business Working Group Key Decisions and Next Steps • Decisions • The WG agreed to focus on developing Business Requirements for the General Use Case using the Business Matrix • Work assignments/Next Steps • Enter business requirements for General Query Health Use Case • Schedule time for self-organized calls to develop business requirements next week

32. Project Charter

33. Scope Clarification & Discussion • Key assumptions: • Initiative will leverage existing distributed query technology (e.g. those identified from the summer concert series) and NwHIN technology as appropriate • Existing S&I ToC data model as the CIM starting point (with extensions if needed for the selected user story) • Key demonstrations • 1 or 2 user stories to pilot and test  • The broader set of user stories is intended to ensure that the architecture framework is robust and extensible • Pilot sites will be selected based on • national priorities • Existing research and health information management infrastructure

34. Project Charter Feedback

35. Open Discussion

36. Next Steps • Identify Working Group leadership • Call for consensus on Charter (third time’s the charm!) – Sept 29 • Face-to-Face Meeting October 18, 19 • Register • Arrange Travel