data access framework (daf) kickoff 7/16/2013
DESCRIPTION
Data Access Framework (DAF) Kickoff 7/16/2013. July 16 th , 2013. Doug Fridsma, MD, PhD, FACP, FACMI Chief Science Officer & Director, Office of Science & Technology John Feikema – Initiative Coordinator Mera Choi – ONC Lead. Meeting Etiquette . - PowerPoint PPT PresentationTRANSCRIPT
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Data Access Framework (DAF)
Kickoff 7/16/2013
July 16th, 2013
Doug Fridsma, MD, PhD, FACP, FACMIChief Science Officer & Director, Office of Science & TechnologyJohn Feikema – Initiative CoordinatorMera Choi – ONC Lead
Meeting Etiquette
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From S&I Framework to Participants:Could you please explain how the terminologies are used in this instance?
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• Opening Remarks - Doug Fridsma, MD, PhD Director, Office of Standards and Technology, ONC
• The Standards & Interoperability Framework• Initiative Introduction • Data Access Framework Initiative
o History
o Importance
o Scope
o Expected Outcomes
o Timeline
• Next Steps/Call for Participation• Questions & Answers• Resources
Agenda
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Office of Science and Technology(OST)
Promote compliance with validated information exchange standards, services and policies to assure interoperability between validated systems
S&I Framework Overview
• Specific health interoperability initiatives guide the design and development of a fully integrated and connected health information system.
• An S&I Initiative focuses on a single challenge with a set of value-creating goals and outcomes, and the development of content, technical specifications and reusable tools and services.
• Call for Participation: The overall success of the S&I Framework is dependent upon volunteer experts from the healthcare industry and we welcome any interested party to get involved in S&I Framework Initiatives, participate in discussions and provide comments and feedback by joining the Wiki: http://wiki.siframework.org
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S&I Framework Coordination
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ONC Programs & Grantees
Community S&I Framework
FACAs
SDOs
• State HIE Program & CoPs• SHARP Program• REC Program & CoPs• Beacon Program
• Technology Vendors• System Integrators• Government Agencies• Industry Associations• Other Experts
• HL7• IHE• CDISC• NCPDP• ASC X12• ASTM• WEDI
• HIT Standards Committee• HIT Policy Committee• Tiger Team
• ISO/TC 215• IHTSDO• NLM• NQF• Regenstrief• Other health IT
standards related organizations
ONC Standards and Interoperability (S&I) Framework Lifecycle
Our Missions» Promote a sustainable ecosystem that drives increasing interoperability and standards adoption» Create a collaborative, coordinated, incremental standards process that is led by the industry in
solving real world problems» Leverage “government as a platform” – provide tools, coordination, and harmonization that will support
interested parties as they develop solutions to interoperability and standards adoption.
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Tools and Services
Use Case Development
and Functional Requirements
Standards DevelopmentSupport
Certificationand Testing
Harmonization ofCore Concepts
Implementation Specifications
Pilot Demonstration Projects
Reference Implementation
Architecture Refinement and Management
S&I Framework Phases & Data Access Framework (DAF)Activities
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Phase Planned Activities Pre-Discovery Development of Initiative Synopsis
Development of Initiative Charter Definition of Goals & Initiative Outcomes
Discovery Creation/Validation of Use Cases, User Stories & Functional Requirements Identification of interoperability gaps, barriers, obstacles and costs Review of Vocabulary
Implementation Creation of aligned specification Documentation of relevant specifications and reference implementations such as
guides, design documents, etc. Validation of Vocabulary Development of testing tools and reference implementation tools
Pilot Validation of aligned specifications, testing tools, and reference implementation tools Revision of documentation and tools
Evaluation Measurement of initiative success against goals and outcomes Identification of best practices and lessons learned from pilots for wider scale
deployment Identification of hard and soft policy tools that could be considered for wider scale
deployments
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A Brief History of the Data Access Framework (DAF)
• BlueButton initiatives enabled patients to access to their own data
• DAF is a similar concept, except it is focused on enabling providers to access their patient’s data both within and across organizations
– Current industry standards are not modular enough to allow the different types of data access desired by Providers
– NwHIN targeted and distributed queries– Multiple ONC initiatives Query Health, Innovation projects
identified multiple data access challenges within and across organizations
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Data Access FrameworkProblems to Solve
• Data Portability– Patient moving from one provider to a new provider
• Quality Improvement– A need for customized “small data analytics” for quality
improvement– NwHIN/Targeted Query
• Remote “chart pulls”• Public Health
– Common framework needed
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• DAF will identify/create/modify standards to solve basic data access issues faced by providers
• within their own organization and across organizations in a modular and substitutable fashion.
• DAF is focused on enabling providers, their tools and applications to access their patient’s data
• Through new or modified standards DAF will allow providers to use new and innovative applications
• improve and fill gaps (such as medication tracking, long term care needs) in patient care
What is DAF
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DAF - Example Real World Scenarios
• A provider wants to access data about a particular population within his/her practice using quality measures
• For example the provider wants to know all diabetic patients with HbA1c > 8% within their organization
• A provider wants to access the complete medical history of a patient to improve care and use new tools and applications to improve care
• Tools include predictive modeling, comparison with existing data sets etc. • Enable applications such as Medication Adherence and Tracking to be
used by patients and care givers.• Enable social workers and other care givers to consume the patient
information and determine the next steps in providing care. These may include determining what kind of long term care facility best suits the patient based on their demographics, diagnosis, medications etc.
• Build an Extraction capability (such as an API) from EMRs
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DAF – Challenge…
• Data Access Framework has to support a wide variety of user stories (sample illustrated in table below)
Data Access Mechanism (Query) FormatsDocument based
accessData element based access
Data Access using quality measures
Granularity of Data being accessed
Patient Level Data
Get me the latest C-CDA or lab result for a patient so that I can check if their HbA1c > 9%
Retrieve dates where the patients HbA1c > 9%
Get patient data for patients between 18 to 75 with HbA1c > 9% during a time frame.
Population Level Data
Get me the latest C-CDA’s for all patients.
Identify and retrieve patients age >=65 who are due for annual Influenza immunization.
Use Quality Measure to retrieve the percentage of diabetic patients with HbA1c > 9% from the population of all diabetics.
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DAF – Challenges Cont’d
• To support the various user stories and access mechanisms there is a need to create a modular and substitutable framework that can be evolve with the industry over time
– Modular framework can be best visualized as a stack of standards with multiple layers independent of each other
– Substitutable standards will provide the ability to replace standards for a single layer and reuse standards from the other layers
Basic Transport Protocols
Application Transport Protocols
Query Structure
Query Vocabularies and Value Sets
Authentication/Authorization
Result Structure
Result Vocabularies and Value Sets
Information Models
Transport Layer
Security Layer
Query Structure
Query Results
Data Model to support queries
Data Access Framework
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Basic Transport Protocols
Application Transport Protocols
Query Structure
Query Vocabularies and Value Sets
Authentication/Authorization
Result Structure
Result Vocabularies and Value Sets
Information Models
DAF – Modularity and Substitutability Challenge
Transport Layer
Security Layer
Query Structure
Query Results
Data Model to support queries
Data Access Framework Initial Candidate Standards
HTTP SMTP
SOAP(IHE SOAP)
RESTful(IHE mHealth)
Direct
TLS+SAML TLS+OAuth2 S/MIME
ebRIM/ebRS HL7 FHIR HL7 HQMF
C-CDA HL7 v2.5.1 QRDA I, II, III
MU2 ModSpec RTM
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Data AccessFramework
Local Access viaIntra-Organization Query
Targeted Access viaInter-Organization Query
Multiple Data Source Access via Distributed Query (Query Health) –
Completed Initiative
Standards based approach to enable access at all levels: Local, Targeted, and Distributed
• Create and disseminate queries internal to organization
• Query Structure Layer • APIs
• Receive standardized responses• Query Results Layer
• Create and disseminate queries to external organization
• Query Structure Layer • Transport Layer• Authentication/Authorization Layer
• Receive standardized responses from external orgs• Query Results Layer
• Create and disseminate queries to multiple orgsGoverned by a network
• Receive aggregated or de-identified responses
• Focus on Information Model for the network and leverage standards from earlier phases.
DataSource
DataSource
DataSource
Query Request
Query Response
X Hospital System X Hospital System
Y Hospital System
DAF – Overall Context
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DAF - Scope
• The work of this initiative will be done in 2 phases:• Phase 1 is focused on Local Access via Intra Organization Query• Phase 2 is focused on Targeted Access via Inter Organization Query
• The following capabilities are In-Scope:• Define the modular layers for Data Access Framework to support
identified business and functional requirements.• Identify the existing standards that can be used for each layer of the
Data Access Framework including guidance for substitutability of standards for both Local Access and Targeted Access.
• Define Implementation Guides leveraging existing standards where necessary to structure queries and query results for identified business and functional requirements.
• Identify standardized APIs that allow applications to query data in a consistent manner across EHRs.
• We will work with FACA and OPP to coordinate policy issues
Organization Entity A
Sends: Data Query
Receives: Patient(s) Data or Document
Information Requester
Internal Information
System
Scenario Example: Information Requester sends a data query to his/her Internal Information System requesting information about one or more patient(s). The Internal Information System returns the requested patient data or document to the Information Requester.
DAF - Local Data Access Workstream via Intra-Organizational Query
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Fire
wal
l
DAF - Targeted Data Access Workstream via Inter-Organizational Query
Organization Entity A
Originating Request System
Data Source System
Sends: Data Query
Receives: Patient(s) Data or Document
Organization Entity B
Scenario Example: Originating Request System from Org A sends a data query to a known external organization requesting information for a known patient to Data Source System from Org B. The Data Source System from Org B returns the requested patient data or document to the Originating Request System in Org A.
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Notional Project Timeline
Kick-off (7/16)Pre-Discovery, Call for
Participation
Jan 2014
Nov
Discovery
S&I Lifecycle(Discovery Pilot & Evaluation)
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July 2013 Sept
Implementation
Define Use Case & Functional Requirements
Standards Gap Analysis Harmonized Specifications
Technology Evaluations
Technical Project Outline (11/14)
Use Case 1 Consented 10/22
UC
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UC
2: Ta
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Discovery
Define Use Case & Functional Requirements
Implementation
Standards Gap Analysis
Use Case 2 Consented 11/29
Charter Review & Consensus
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Logistics
• We will be meeting as a community every week on Wednesdays
• This will be a 60 minute meeting
• Community Meeting Time
• Wednesdays 12:00-1:00 EST
• All Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Use Case, Project Charter and General Data Access Framework information will be posted on the Data Access Framework Wiki page
• Join us for our next meeting July 24th, 2013
• See the wiki page for the meeting updates
http://wiki.siframework.org/Data+Access+Framework+Homepage
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Data Access Framework Wiki Page
http://wiki.siframework.org/Data+Access+Framework+Homepage
Data Access Framework Wiki Page
Next Steps – Sign Up• The ONC Data Access Framework Initiative is open for anyone
to join.
• This community will meet frequently by webinar and teleconference
• We use Wiki pages to facilitate discussion.
• Information on how to join the Community can be found on the Data Access Framework Sign Up Wiki: http://wiki.siframework.org/Data+Access+Framework+Join+the+Initiative
• In order to ensure the success of our initiative and the subsequent pilot, we encourage broad and diverse participation from the community.
• This is your chance to have an impact on the creation and implementation of a pilot program in this important area of health IT development.
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Next Steps – Getting Started
• Details on the Data Access Framework launch including this presentation are posted on the wiki: http://wiki.siframework.org/Data+Access+Framework+Homepage
• Please feel to review and comment on the Proposed Project Charter
• To review the Data Access Framework Project Charter go to the Charter wiki page: http://wiki.siframework.org/Data+Access+Framework+Charter+and+Members
• Complete the Data Access Framework Project Charter Comment Form: http://wiki.siframework.org/Data+Access+Framework+Charter+and+Members (you will need to select the “Click Here to Provide Comments” in the Project Charter Comments Section)
• Join us for our next meeting July 24th, 2013 from 12-1 pm EST
• All meeting updates, call in number and web meeting details can be found here: http://wiki.siframework.org/Data+Access+Framework+Homepage
Resources and Questions• Please feel free to reach out to any member of the Data Access
Framework Initiative team:• Initiative Coordinator:
• John Feikema: [email protected] • ONC Sponsors
• Mera Choi: [email protected] • Support Team:
• Project Management: Jamie Parker [email protected] and Gayathri Jayawardena [email protected]
• Technical Support: Dragon (Nagesh) Bashyam [email protected]
• Use Case Development: Presha Patel [email protected]• Vocabulary and Terminology Subject Matter Expert: Mark Roche
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