Retrieve Form for Data Capture (RFD)

Retrieve Form for Data Capture (RFD) Interoperability Showcase World of Health IT Didi Davis, Director IHE/HIMSS Courtesy of: George Cole (Allscripts), Landen Bain (CDISC), Kevin Kelly (IBM)

Agenda • RFD Overview • Profile Actors and Transactions • XForms

RFD Overview • Goals • Use Cases • Example of Motivation for RFD

Retrieve Form for Data Capture • A standard way of displaying external data capture forms inside an EHR. • Many-to-many integration – any EHR can retrieve forms from many external systems. • Low barrier of entry for EHR and external systems. • Flexible profile to accommodate both low-tech and sophisticated implementations.

Five Use Cases • Investigational New Drug Trials • EHR linked to pharma sponsor via EDC. • Bio-surveillance • EHR linked to local and national bio-surveillance systems. • Pharmaco-vigilance • EHR linked to FDA and sponsors. • Cardiology research data registry • EHR linked to NCDR, US national registry. • Radiology • EHR linked to National Oncologic PET Registry

FDA Critical Path Initiative • Opportunities List • http://www.fda.gov/oc/initiatives/criticalpath/reports/opp_list.pdf • Streamlining the Clinical Trial Process • 44. Development of Data Standards. • 45. Consensus on Standards for Case Report Forms.

Item 44. Development of Data Stds. Development of Data Standards. Currently, clinical investigators, clinical study personnel, data managers, and FDA reviewers must cope with a plethora of data formats and conventions. Some clinical investigators report the presence of many different computer systems for data entry at their sites (for various trials), each of which uses different data conventions. Lack of standardization is not only inefficient, it multiplies the potential for error. …

Current StateData Capture: Some Sites Looks Like This The virtual version of this mess – multiple web apps on one workstation – is scant improvement.

How widespread is this problem?2/3 of sites have more than one data capture system.17% have 5 or more! Source: CDISC 2004 Research Project, Analysis Q200_1 & Q200_2

RFD Profile • Initial Phase • Define standard format for forms • Define standard method for retrieving and submitting forms • Content Profile Phase • Provide domain-specific form requirements • Enable form population from EHR mapped data

RFD Format of a Form • RFD forms are XForms • RFD XForms must conform to profile constraints • …XForms overview is coming…

RFD Retrieve and Submit • An actor for Retrieving XForms • XForms, by their definition, contain the Submission mechanism • An actor for supplying XForms • An actor for receiving submitted instance data

Actors and Transactions

RFD Actors • Form Filler • Retrieves a List of XForms from a Form Manager • Queries a Form Manager for a List of Available FormIDs • Form Manager • Supplies a List of XForms upon request • Supplies a List of Available FormIDs • Form Receiver • Receives the submitted Instance Data

RFD Transactions • Retrieve Forms • Supply a FormID to Form Manager to retrieve a List of XForms • Query Form Manager • Supply a set of (name,value) pairs to a Form Manager to retrieve a List of FormIDs • Submit Form • XForm Submit action, Posting Instance Data to a Form Receiver • Archive Form • Think of this as a Carbon Copy feature • Optional XForm Submit action for Form Fillers to use

Retrieve Forms • SOAP to Form Manager providing FormID • Form Manager returns a List • The List may be empty (No XForms for the given FormID) • Each item in the List contains • An XForm • Optionally, metadata (name,value) pairs about XForm • The Profile will provide Schema

Query Form Manager • SOAP to Form Manager supplying (name,value) pairs • Form Manager returns a List • The List may be empty • Each item in the list contains: • A FormID • Metadata (name,value) pairs • The Profile will provide Schema

Actors and Transactions

Example • One Form Manager • Form Fillers A, B, and C • Each Form Filler Retrieves FormID “123” • Assume FormID “123” maps to just one XForm • Form Fillers A and C Archive upon Submit

Archive upon submit Archive upon submit Retrieve Forms “123” Submit Retrieve Forms “123” Submit Submit Retrieve Forms “123” Document Vault A Document Vault C Form Filler A Form Filler B Form Filler C Form Manager Form Receiver

XForms • XML Powered Forms • Standards-based • World Wide Web Consortium (W3C) specification • http://www.w3.org/MarkUp/Forms/ • Platform independent • Capable of embracing many devices • Produces a user interface appropriate for the connecting device • Gaining support in browsers • Firefox (Windows, Linux, and Mac), and Internet Explorer

Why XForms? • Open W3C standard – no proprietary lock-in • Single instrument for all platforms – leaving rendering as a client decision • Off-line and on-line data collection • Can implement public-health business rules • Required fields • “Skip patterns” based on user response, such as branch, reveal/hide fields • Binding of questions to schema and vocabulary • Integrated instrument submittal • No scripting – faster creation of instruments

Goals of XForms • Rich, XML-based, forms to meet the needs of business and consumer web applications • Support for desktop browsers and other mobile devices • Decoupled data, logic, and presentation • Reduce/eliminate the need for script • Support for structured form data in all XML • Advanced forms logic

How XForms Works • Model-View-Controller • Model: XML data model • View: XForms controls • Input, Select, Select1, Date Pickers,Range, … • Final rendering is decided “on the glass” • Controller: XForms processor • Submit • Binds

RFD XForms from a Form Manager • Contained within a List • May be partially complete • Instance Data may have some values • Will have one bound Submit • Will enable an additional submit binding

XForms 1.0 Browser Support • Internet Explorer 6.x • formsPlayer (now, free to render) • http://www.formsplayer.com/download/download.jsp • Firefox (under development, free) • Joint effort between Mozilla and IBM • http://www.mozilla.org/press/mozilla-2004-08-10.html • X-Smiles (now, free) • http://www.x-smiles.org/

RFD XForm: Submit & Archive • An RFD XForm always submits to Form Receiver • An RFD XForm may also archive instance data • Form Fillers know archive (vault) locations • RFD XForms have no archive location knowledge • RFD XForms enable archiving as an optional feature

Enabling Archiving • RFD XForms enable this as a feature • Exact details are still being tested • Need method that works on all platforms

RFD Profile Development • Working in ITI Technical Committee • Volunteer time as a technical contributor • Email group exists: itirfd@rsna.org • Send requests to LPalmer@himss.org

References • XForms • XForms 1.0 (Second Edition) http://www.w3.org/TR/2006/REC-xforms-20060314/ • Comparison of XForms and HTML forms http://en.wikipedia.org/wiki/XFormsW3C XForms Turtorial http://www.w3schools.com/xforms/default.asp • XForms Renderer/Browsers • Mozilla XForms project page http://www.mozilla.org/projects/xforms/ • X-Smiles (an open XForms renderer/browser) http://www.xsmiles.org/ • formsPlayer (IE plugin) http://www.formsplayer.com/content/index.html

Retrieve Form for Data Capture (RFD)