Data Access Framework (DAF) Kickoff 7/16/2013

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

1

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•
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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

3

Office of Science and Technology
(
OST
)

Promote compliance
with
validated information exchange
standards, services and policies to
assure interoperability between
validated systems


4

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


5

S&I Framework Coordination

6

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.

7

Tools and Services


Use Case
Development

and Functional
Requirements


Standards Development

Support


Certification

and Testing


Harmonization of

Core Concepts


Implementation
Specifications


Pilot Demonstration
Projects


Reference
Implementation

Architecture Refinement and Management

S&I Framework Phases &

Data Access Framework (DAF)Activities

8

Phase

Planned
Activities

Pre
-
Discovery


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Discovery

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
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Implementation

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
Validation of Vocabulary


Development of testing tools and reference implementation tools

Pilot


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Evaluation

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
Identification of best practices and lessons learned from pilots for wider scale
deployment


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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


9

Data Access Framework

Problems 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

10

•
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

11

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


12

DAF
–

Challenge…

•
Data Access Framework has to support a wide variety of user
stories (sample illustrated in table below)

13



Data Access Mechanism (Query) Formats

Document based
access

Data 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

HbA
1
c

>

9
%

during

a

time

frame
.

Population

Level

Data

Get me the latest C
-
CDA’s for all patients.

I摥dtif礠
慮搠
retriev攠灡ti敮t猠
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.

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/Autho
rization

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

14

Basic Transport
Protocols

Application Transport
Protocols

Query Structure

Query Vocabularies
and Value Sets

Authentication/Autho
rization

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

15

Data Access

Framework

Local Access via

Intra
-
Organization Query

Targeted Access via

Inter
-
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

o
rganization

•
Query Structure Layer

•
Transport Layer

•
Authentication/Authorization Layer

•
Receive standardized
responses from external orgs

•
Query Results Layer

•
Create and disseminate queries to multiple orgs

Governed by a network


•
Receive aggregated or de
-
identified responses


•
Focus on Information Model for the network and

l
everage standards from earlier phases.

Data

Source

Data

Source

Data

Source

Query
Request

Query
Response

X Hospital System

X Hospital
System

Y

Hospital
System

DAF
–

Overall Context

16

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

17

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

18

Firewall

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.

19

Notional Project Timeline

Kick
-
off
(7/16)

Pre
-
Discovery,
Call for
Participation

Jan

2014

Nov

Discovery

S&I Lifecycle

(Discovery


Pil潴 & E癡v畡ui潮)

20

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 1: Local Data
Access
: Intra
-
Organizational
Query

UC 2: Targeted Data
Access
: Inter
-
Organizational Query

Discovery

Define Use Case & Functional
Requirements

Implementation

Standards Gap
Analysis

Use Case 2 Consented
11/29

Charter
Review &
Consensus

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




21

Data Access Framework Wiki Page

http://
wiki.siframework.org/Data+Access+Framework+Homepage


Data Access Framework Wiki
Page

22

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+Initi
ative


•
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.


23

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+Me
mbers


•
Complete the Data Access Framework Project Charter Comment Form:
http
://wiki.siframework.org/Data+Access+Framework+Charter+and+Me
mbers

(you will need to select the “Click Here to Provide Comments” in
the Project Charter Comments Section)

•
Join us for our next meeting July 24
th
, 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

24

Resources and Questions

•
Please feel free to reach out to any member of the Data Access
Framework Initiative team:

•
Initiative Coordinator:

•
John Feikema:
john.feikema@siframework.org


•
ONC Sponsors

•
Mera Choi:
mera.choi@hhs.gov


•
Support Team:

•
Project Management
: Jamie Parker
jamie.parker@esacinc.com

and
Gayathri
Jayawardena
gayathri.jayawardena@esacinc.com


•
Technical Support
: Dragon (Nagesh) Bashyam
nagesh.bashyam@drajer.com


•
Use Case Development
: Presha Patel
presha.patel@accenture.com

•
Vocabulary and Terminology Subject Matter Expert
: Mark Roche
mrochemd@gmail.com




25