Query Health Concept-to-Codes (C2C) SWG Meeting #12

1. Query Health Concept-to-Codes (C2C) SWGMeeting #12 March 6, 2012

2. Agenda

3. Query Health CEDD • Data Dictionary that • Identifies the data elements required for composing queries • Identifies the vocabularies that are used to represent certain elements • Reuses Value Sets where applicable to represent the values for data elements • Is “Implementation Independent” • Can be implemented using different platforms (i2B2, hQuery, PopMedNet) • Aligned with overall S&I Framework CEDD • Alignment with QDM, Consolidated CDA, FHIM and other data models is underway • http://wiki.siframework.org/Query+Health+Clinical+Element+Data+Dictionary+%28CEDD%29

4. Query Health CEDD Top Level Information Requestor Data Source Query Translation and Execution Query Composition Local Data Elements and Codes in Clinical Records CEDD Space

5. Value of Query Health CEDD • Provides the capability to map queries to data elements consistently • Allows data sources to map to data elements and concepts • Allows queries to run universally across different types of data sources • Is Aligned to MU Stage 2 , QDM, ACO and other models

6. Query Health CEDD - Details Query Composition Framework 1A. Uses data elements to compose queries Patient Encounters CEDD 1B. Reference Implementations of CEDD Medications Problems …..etc Query Execution Framework 2. Data Element Mapping 3. Concept/Code Mapping 4. ETL Process leveraging local mappings* to load database for execution PopMedNet Schema Local Encounters Local Patient hQuery JSON Schema Local Medications Local Problems …..etc i2B2 STAR Schema Local Data Source Query Health Data Source * - Non ETL Approaches are also available for execution (C32 based integration, Native HQMF Integration)

7. i2B2 Demo • Purpose: • Demonstrate the Query Composition Framework • Specific focus on Ontology and how it is used to compose Queries • Value Sets and how it can be leveraged with the i2B2 framework

8. i2B2 Demo Discussion • What should be part of the Concept Hierarchy • For e.g, Query Health can use MU Stage 2 (NPRM) Vocabularies without higher level concepts (Usabillity ?) • Lab – LOINC • Medications – Rxnorm • Problem Lists - SNOMED-CT • Discharge Diagnosis - ICD10-CM • Immunizations – CVX • Demographics preferred language - ISO 639-1 • Demographics preliminary cause of death ICD10-CM • For e.g, Query Health can build on i2B2, NQF, PCIP, NLM, PHIN-VADS and use higher level concepts mapped to these underlying vocabularies and codes • If we wanted to do this ..we should do it in a standards based manner (IHE SVS provides a mechanism to expose these value sets) • Concept Hierarchy can be represented using the existing i2B2 mechanisms • Feedback on Approaches

9. IHE SVS Profile and its applicability • http://www.ihe.net/Technical_Framework/upload/IHE_ITI_Suppl_SVS_Rev2-1_TI_2010-08-10.pdf • Trial implementation standard • SVS defines the transmission protocols for a network access to a terminology server focused specifically on the distribution of Value Sets. 320 • Why are we discussing this ? • Queries in HQMF use value sets either inline or as an external link to a value set • Sharing Value Sets (SVS) becomes very important in this regard. • Should we standardize around this and make it part of our recommended technical standards ? • Protocol for the Consumer • Consumer side: Simple HTTP based protocol cane be used to retrieve the value set information • Use a simple HTTP GET in a RESTful manner • SOAP option also exists.

10. IHE SVS Profile and HQMF Sample • HQMF Samples Referring to Value Sets (Posted in the RI Repository) • Data Criteria section: • <entry> • <localVariableName>HasDiabetes</localVariableName> • <observationCriteria><id extension="HasDiabetes" root="0"/> • <statusCode code="completed"/> • <value xsi:type="CD" valueSet="2.16.840.1.113883.3.464.1.37"/> • <definition> • <observationReferencemoodCode="DEF"><id extension="Problem" root="0"/></observationReference> • </definition> • </observationCriteria> • </entry>

11. IHE SVS Value Set Example • Value Set sample • Link: SVS.xml posted on the Repository http://code.google.com/p/query-health

12. Using IHE SVS in Query Health • Pre-load Concept Hierarchy from reliable sources such as NQF and use it for query definition • Identify the Folder Structure that we want for Query Health Pilots • What should the nesting level be….? • What is appropriate for Query Health ? • Concept Hierarchy can be represented as discrete codes or Reference a Value Set OID • Map Local Data to Query Health CEDD + selected Value Sets

13. Leveraging IHE SVS for Query Health • Concept Hierarchy can be constructed using value sets from NQF, PCIP and other sources. • Need to validate with i2B2 Experts. • Translate OID’s to local codes as required on Query Composition or Execution Use OID’s or discrete codes

14. Using IHE SVS in Query Health • What do we need to be able to use SVS: • Organizations such as NQF need to standup a RESTfulWeb service to provide the Value Set • Develop Ontology Cell Builder software to load Ontology from these RESTful web services • Create Value Set OID’s as Query Health Pilots develop Value Sets and publish them through the RESTful web service