Query Health Concept-to-Codes (C2C) SWG

Meeting #12

March 6, 2012

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Agenda

Topic Time Slot

Query Health CEDD 2:30 – 2:50 pm

i2B2 Demo 2:50 – 3:10 pm

IHE SVS Profile and Query Health Technical Approach

3:10 – 3:30 pm

General Discussion and Community Feedback

3:30 – 4:00 pm

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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

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Query Health CEDD Top Level

Query Composition

Query Translation

and Execution

Local Data Elements

and Codes in Clinical Records

Information Requestor Data Source

4

CEDD Space

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

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Query Health CEDD - Details

Patient

Medications Problems

Encounters

…..etc

CEDD

Query Composition Framework

1A. Uses data elements to compose queries

Local Data Source

Local Patient

Local Encounters

Local Medications

Local Problems …..etc

2. Data Element Mapping

3. Concept/Code Mapping

1B. Reference Implementations of CEDD

i2B2 STAR Schema

hQuery JSON Schema

PopMedNet Schema4. ETL Process leveraging local mappings* to load database for execution

Query Execution Framework

* - Non ETL Approaches are also available for execution (C32 based integration, Native HQMF Integration)

Query Health Data Source

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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

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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

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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.

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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>

• <observationReference moodCode="DEF"><id extension="Problem" root="0"/></observationReference>

• </definition>• </observationCriteria>

• </entry>

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IHE SVS Value Set Example

• Value Set sample

• Link: SVS.xml posted on the Repository http://code.google.com/p/query-health

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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

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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

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Using IHE SVS in Query Health

• What do we need to be able to use SVS:

• Organizations such as NQF need to standup a RESTful Web 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

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