data access framework (daf) john feikema onc initiative coordinator
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Data Access Framework (DAF)
John Feikema ONC Initiative Coordinator
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• Wide spread use of HealthIT systems (EHRs, Data Warehouses, etc.) has created opportunities for healthcare organizations and their teams to access and use the patient data that is already collected during clinical workflows.
• However, Health IT systems may be limited in their ability to perform data queries, APIs, or services to access data sets.
• Therefore, creating an industry standard access methods is needed:– To expand the ability of users to create value out of their data– To enable a provider to understand a patient’s overall health
and the health of a provider’s collective patient population– To use the data to power innovative new applications and tools to
take better care of patients and populations.
Data Access Framework
Understanding the Challenge
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• Enable Local and Targeted data access using the various data access mechanisms (document based, data element based, quality measure based, etc.)
• Identify privacy and other necessary metadata to enable the various data access mechanisms
• Modularize the query stack into modular layers (transport, query structure, query results, authentication, etc.) and allow for substitutability at each layer of the query stack
• Identify the set of modular components and industry standards that should be assembled together as valid combinations to promote interoperability for the various business requirements of the community.
Data Access Framework
Addressing the Challenge
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• To develop a framework that seeks to identify, create and/or modify standards to solve basic data access issues faced by providers – Within their own organization and across organizations in a modular
and substitutable fashion
• To enable providers, their tools and applications, to accesstheir patient’s data
• Allow providers to use new and innovative applications,through new or modified standards– Improving and filling gaps (e.g. medication tracking,
long term care needs in patient care)
Data Access Framework
Purpose of DAF
Data AccessFramework
Data AccessFramework
Local Access viaIntra-Organization Query
(Complete)
Local Access viaIntra-Organization Query
(Complete)
Targeted Access viaInter-Organization Query
(Complete)
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
Organization X Organization X
Organization Y
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DAF Scope
Focus Areas
Note: An organization can be a hospital that is part of a larger organization and can also include HIEs, RIOs, other types of organizations etc.
Note: An organization can be a hospital that is part of a larger organization and can also include HIEs, RIOs, other types of organizations etc.
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• A provider wants to access data about a particular population within his/her practice using quality measures– E.g. the provider wants to know all diabetic patients over the age of
65 with HbA1c > 7% 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
Data Access Framework
Example of a Real World Scenario
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Data Access Framework
Mechanisms
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Data Access Framework
Draft Query Stack• To address mechanisms, multiple
standards across multiple layers must be present– Transport Layer: getting patient
data from one place to another– Security Layer: ensuring data
will only be accessible to authorized parties.
– Query Structure: making sure the “question” being asked is phrased appropriately for the data to answer it.
– Query Results: appropriately formatting the “answer” to the question posed.
– Data Model to Support Queries: information models that define concepts used in clinical care.
Notional Project Timeline
DAF Initiative Kickoff (7/16)
Discovery (Use Case 1) Discovery (Use Case 1)
S&I Lifecycle(Discovery Pilot & Evaluation)
August November
Define Use Case & Functional Requirements
Define Use Case & Functional Requirements
Sub-Work Group
Signifies milestone or deliverable
July 2013
September
October December
UC 1 Kickoff (8/14)
Project Charter Consensus (8/28)
UC 2 Kickoff (12/11)
UC 1 Consensus (12/11)
UC
1:
Local
Data
Access:
Intr
a-
Org
an
izati
on
al
Qu
ery
Pre-Discovery Pre-Discovery
Develo
pm
en
t of
Ch
art
er
Define Use Case & Functional
Requirements
Define Use Case & Functional
Requirements
Implementation (DAF/IHE Community)
Implementation (DAF/IHE Community)
Discovery (Use Case 2) Discovery (Use Case 2)
UC
2:
Targ
ete
d D
ata
A
ccess:
Inte
r-O
rgan
izati
on
al
Qu
ery
Sub-Work Group
DAF IHE/ S&I Joint Work Group
IHE A
cti
vit
ies
Notional Project Timeline CONTINUED
S&I Lifecycle(Discovery Pilot & Evaluation)
Today 3/18
February May
Signifies milestone or deliverable
March April June
Define Use Case & Functional
Requirements
Define Use Case & Functional
Requirements
Discovery (Use Case 2)
Discovery (Use Case 2)
UC 2 Consensus (2/5)
Draft DAF/IHE White Paper Complete (2/28)
DAF/IHE White Paper Published
January2014
UC
2:
Targ
ete
d
Data
Access:
Inte
r-O
rgan
izati
on
al
Qu
ery
Implementation (DAF/IHE Community) Implementation (DAF/IHE Community)
DAF IHE/ S&I Joint Work GroupIHE A
cti
vit
ies
Publish DAF/IHE White PaperPublish DAF/IHE White Paper
IGConsensus
Implementation (S&I Community) Implementation (S&I Community)
Implementation (S&I Community) Implementation (S&I Community)
Candidate Standards
Analysis
Candidate Standards
Analysis
TW
G 1
: D
ocu
men
t M
eta
data
based
access f
or
LD
AF
& T
DA
F
Finalize Actors + Transactions +
Technology Stacks and Standards
Finalize Actors + Transactions +
Technology Stacks and Standards
Create IG’s based on existing standards
Create IG’s based on existing standards
Create SWG to modify/add standards as necessary
Update IG’s based on SWG
output
Candidate Standards Analysis
Candidate Standards Analysis
Finalize Actors + Transactions + Technology Stacks and Standards
Finalize Actors + Transactions + Technology Stacks and Standards
Create SWG to profile standards for data element
accessTW
G 2
: D
ata
Ele
men
t b
ased
access
for
LD
AF &
TD
AF
White Paper Comment Period
White Paper Comment Period
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• HITPC and HITSC guidance on queries• ONC Innovation community work• Meaningful Use Stage 2 standards where applicable• Industry work related to queries as appropriate• eHealth Exchange standards related to queries as
appropriate.• "EHR|HIE Interoperability Workgroup" work related to
queries as appropriate.• Existing standards from IHE and HL7
Data Access Framework
Strategic Alignment
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Data Access Framework
Relevant Stakeholders
Individual Providers Provider Organizations Query Thought Leaders
Government Agencies
Standards Organizations
HIE/HIO
HIT Vendors-EHR/EMR/P
HR
Other Healthcare Vendors
Privacy and Security Experts
Patients Patient Advocates Beacon Communities
Federal Agencies Public Health Agencies3rd Party Clinical
Application Vendors
Healthcare Organizations
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Data Access Framework Resources• To take part in our current Harmonization and Standards work activities visit: http://wiki.siframework.org/DAF+Standards+Harmonization+and+Implementation
• To join our weekly webinars, visit the DAF Wiki Homepage for the latest meeting information: http://wiki.siframework.org/Data+Access+Framework+Homepage
• To subscribe to our mailing list, simply complete the “Join this Initiative” Form: http://wiki.siframework.org/Data+Access+Framework+Join+the+Initiative
• To access current and archived meeting materials, visit the Project Meeting Artifacts section: http://wiki.siframework.org/Project+Meeting+Artifacts
Questions
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Initiative Support Leads• Initiative Coordinator: John Feikema john.feikema@siframework.org• ONC Sponsor: Mera Choi mera.choi@hhs.gov• Support Team:
– Project Management: • Gayathri Jayawardena gayathri.jayawardena@esacinc.com
– Technical Support: • Dragon (Nagesh) Bashyam nagesh.bashyam@drajer.com
– Use Case Development: • Presha Patel presha.patel@accenture.com• Hema Patel hema.patel@accenture.com
– Standards Support: • Angelique Cortez angelique.j.cortez@accenture.com
– Vocabulary and Terminology Subject Matter Expert: • Mark Roche, MD mrochemd@gmail.com
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