Population CCR - Query Health Summer Concert Series

Population CCR is an approach for simplifying and integrating performance reporting and decision support. It fulfills a need for decoupling of analytics from current and future health IT systems. It eases the creation of rules by non-programmers and harmonizes the representation of clinical data across patient records, performance reporting, and decision support - all by using widely accepted standard technologies. Steven Waldren presents.


Query Health - Population CCR Presentation from S&I Framework on Vimeo.

caGrid - Query Health Summer Concert Series

caGrid is an open‐source framework that addresses the needs of a heterogeneous community to access, integrate, and analyze biomedical data of diverse nature and source. This platform allows diverse, authorized applications, running on multiple platforms, to access appropriate data (both individual level and aggregated) from distributed sources. It permits simple access to unrestricted data using standard internet technology as well as secure access by authorized “virtual communities” to sensitive, restricted digital resources using community‐developed caGrid technology. Ken Buetow presents.


Query Health - caGrid Presentation from S&I Framework on Vimeo.

UPHN - Query Health Summer Concert Series

New York’s Universal Public Health Node (UPHN) Initiative is a strategic organizational process, informatics approach and technical infrastructure to transform public health practice through health information exchange in New York. The UPHN enables the integration of the public health practice across the health enterprise as part of the business model for effective and economical health care delivery. UPHN helps improve the efficacy of public health practice through authorized program access to integrated longitudinal health information assets.  Ivan Gotham, Lee Jones and Vince Lewis present.


Query Health - UPHN Presentation from S&I Framework on Vimeo.

Angular Momentum - a true love story

Mouse-over:  With reasonable assumptions about latitude and body shape, how much time might she gain them?  Note: whatever the answer, sunrise always comes too soon. (Also, is it worth it if she throws up?)

The artist is one of many families dealing with the struggles and heartbreak of cancer (http://blog.xkcd.com/2011/06/30/family-illness/)

Published under Creative Commons license

The August HIT Standards Committee Meeting

By John Halamka, Life as a Healthcare CIO

 The August meeting of the HIT Standards Committee (the 28th meeting of this FACA) was a milestone in parsimony.   As you'll see, we approved a set of vocabulary recommendations and public health standards that represent harmony as well the fewest number of standards possible for the intended purpose. 

Since April, we've been working hard on Summer Camp.   At our September meeting, we'll wrap up all that work and hand off the finished standards recommendations to ONC for regulation writing.

Per our Summer Camp plan, the August meeting included final recommendations on vocabulary standards for quality measures, final recommendations on all public health transactions, preliminary recommendations on patient matching, and preliminary recommendations on transport/security standards.   We also heard from the Standards and Interoperability Framework team about their work and the Implementation Workgroup on their review of Certification Criteria.

This was a powerful meeting, discussing the standards that so many people have been working on for the past decade - one vocabulary standard for each class of data used in quality measures, one approach to public health transactions, one approach to transfer of care summaries, one approach to laboratory results, and a building block approach to data transmission that supports the portfolio of health information exchange options.

We began with the final recommendations from the Clinical Quality Workgroup and Vocabulary Task force on vocabulary standards.   Per the marching orders we gave them, they selected one vocabulary standard for each domain - problems, medications, allergies, labs etc.    SNOMED-CT and LOINC are the default vocabularies used whenever possible.   The committee approved these recommendations by consensus with 2 caveats

-the Implementation Workgroup will be charged with ongoing review of the implementation burden of using these standards in a variety of settings
-the September meeting of the HIT Standards Committee will include discussion of a transition plan for those vocabulary standards required for Stage 1 that are being retired/replaced in Stage 2.

Marc Overhage presented best practices for patient matching, identifying the metadata that should be standardized in patient records and health information exchange.   These recommendations are complementary to the metadata standard recommendations in the Advanced Notice of Proposed Rulemaking, enabling stakeholders to optimize a patient matching strategy as needed for their applications using best practices and evidence from industry experience.

Chris Chute presented the recommendations for public health standards  - one HL7 2.51 implementation guide for surveillance, one HL7 2.51 implementation guide for immunizations and one HL7 2.51 implementation guide for reportable labs.   The optionality specified in meaningful use stage 1 was eliminated and the end result are simple un-ambiguous implementation guides for public health.

Dixie Baker presented the preliminary recommendations for building blocks that support data exchange in both "push" and "pull" models.   The key innovation in Dixie's is the process for reviewing existing standards for appropriateness, adoption, maturity, and currency.

Jitin Asnaani from ONC presented the S&I Framework update including Certificates, Lab Results, Transitions of Care, and Provider Directories. These will be reviewed and hopefully turned into guidance for ONC in the next few months.

Finally, Judy Murphy and Liz Johnson presented their work on certification criteria.

A remarkable meeting from a world class team.  I'm proud to be a part of it!

hQuery - Query Health Summer Concert Series

Andy Gregorowicz presents MITRE’s work on hQuery. hQuery uses pervasive internet-based technologies to deliver flexible easy-to-understand queries and distributed ultra-large scale query execution capabilities.


Query Health - hQuery Presentation from S&I Framework on Vimeo.

PopMedNet - Query Health Summer Concert Series

PopMedNet uses distributed networks to analyze data from multiple organizations in order to aggregate information for secondary use (use other than direct patient care or administration) such as disease surveillance, comparative effectiveness, and medical product safety. In one example, the FDA identified final specifications for a query to monitor the cardiac outcomes of a particular drug. Using PopMedNet, the specs were distributed to 17 data partners with a combined 99 million individual users. Within an incredible turnaround time of two days a report was delivered outlining statistics about new users (including distributions by age, sex, year, and health plan), first treatment exposure duration, and cardiac outcome diagnoses during treatment. Platt and Brown also emphasized the importance of governance among participants in a distributed network in order to perform successful queries. PopMedNet’s flexibility allows for each network of participants to create, administer and govern their own networks. However, this puts the responsibility of governance on the individual networks to determine the data standards and best practices for their needs. Therefore, the success of PopMedNet relies heavily on its support for the governance principles of the participating organizations.  Rich Platt and Jeff Brown of Harvard Medical School’s Department of Population Medicine present.


Query Health - PopMedNet Presentation from siframework on Vimeo.

Hotspotting with Atul Gawande

Watch the full episode. See more FRONTLINE.