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Query Dispatch and Aggregate QDA Work Item Proposal February 10-14 th , Vienna IHE F2F meeting

Query Dispatch and Aggregate QDA Work Item Proposal February 10-14 th , Vienna IHE F2F meeting. Vincent van Pelt (Nictiz) Mark Sinke (ForCare) Walco van Loon (ForCare) Albert-Jan Spruyt (Nictiz). Business needs.

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Query Dispatch and Aggregate QDA Work Item Proposal February 10-14 th , Vienna IHE F2F meeting

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  1. Query Dispatch and AggregateQDA Work Item ProposalFebruary 10-14th, Vienna IHE F2F meeting Vincent van Pelt (Nictiz) Mark Sinke (ForCare) Walco van Loon (ForCare) Albert-Jan Spruyt (Nictiz)

  2. Business needs • Healthcare professionals need up-to-date summaries containing the most current medical information about the patient • These summaries are made by aggregating information (“building blocks”) from different sources that each generate a different part of the information • These different systems use different query methods • The information from these systems may be created on the fly (from their database), or they can be already existing documents • The information building blocks coming from different systems need to be aggregated into one summary • -> Need for a profile that can take care of complex multi-query creation and result aggregation

  3. Use Cases • On-Demand Medication Overview • Prescriptions • Dispensations • Allergies, contra-indications • Relevant diagnoses • Relevant lab values • On-Demand Patient Summary • Derives building blocks from multiple systems • ‘Blue button’ creation? • On-Demand Emergency Care Summary • Combined information from emergency call center, ambulance, Emergency department, ICU • On-Demand Integrated Care Overview • Combined information from PCP, dietician, physiotherapist, laboratory, etc. • On-Demand Laboratory List • Aggregated overview of laboratory results from different dates and locations

  4. QDAQuery Distribute and Aggregate • Generic profile for the on-demand creation of multi-source summaries and aggregated reports • Process : • One report request simple parameters • Multiple queries to several data-sources queries on live data and / or (extracts from) existing documents different query methods (any method) pre-defined results (CDA templates, messages) • Processing and aggregation parsing of structured information reconciliation and re-ordering of information filling the master report template signing, encryption • One report resultreturns the result in a predefined format (master template)

  5. Internals (draft) • Report request: MedSumm 1 • Query results .... Aggregation • Report result: MedSumm 1 • Query result 2 • Query result 1

  6. Internals (draft) • Report request: MedSumm 1 • Query results .... Aggregation • Report result: MedSumm 1 • Query result 2 • Query result 1

  7. ITI infrastructure and PCC infostructure Create Multi-Source Summary (ITI-xx) 6. One report result 1. One report request QDA ‘Request Subquery ‘(ITI-xx) QDA Query Distributor QDA QD Config. XDS QDA Results Aggregator QDA RA Config. RECON CDA XCA (+ ODD) Conv. CDA DEN XCF 2a. Send out multiple queries 6. Post-processing CDA DSG XDS Q+R (ODD) CDA Report CDA QED MCV CDA 2b. Collect resulting CDA documents HL7 V2 CR Query Conv. CDA RESTful 5. Processing (merge) Conv. CDA Web Service Conv. CDA • ITI notes: • Actors / profiles in brown are not part of the QDA profile, but can be called by a QD transaction • It is up to the implementers which of the brown profiles are deployed • PCC notes: • Query results from the Query Distributor can come from existing documents, but also from ‘live’ databases • For an ‘autofill’ of a certain report, both the master template and the subqueries must be specified (in green) 5. Retrieve ‘Submission Set’ 3. Provide and Register ‘Submission Set’ XDS CDA Query results CDA Master Template

  8. XDS Document Registry Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41)

  9. XDS + ODD Document Registry Register On-DemandDocument Entry(ITI-61) Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41) On-Demand Document Source

  10. XDS + ODD (+ persistent storage) Document Registry Register On-DemandDocument Entry(ITI-61) Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41) Provide and Register Document Set (ITI-41) On-Demand Document Source

  11. XDS + ODD + ? Document Registry Register On-DemandDocument Entry(ITI-61) Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41) Provide and Register Document Set (ITI-41) On-Demand Document Source Not defined how this profile creates the on-demand document

  12. QDA Document Registry Register On-DemandDocument Entry(ITI-61) Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41) Provide and Register Document Set (ITI-41) On-Demand Document Source Create Multi-Source Summary (ITI-xx) QDA Content Creator

  13. QDA Document Registry Register On-DemandDocument Entry(ITI-61) Registry Stored Query (ITI-18) RegisterDocument Set (ITI-42) Retrieve Document Set (ITI-43) Document Source Document Repository Document Consumer Provide and Register Document Set (ITI-41) Provide and Register Document Set (ITI-41) On-Demand Document Source Create Multi-Source Summary (ITI-xx) EHR CDA • HL7 Care Record Query • QED • XCF • XDS Retrieve Document Set • XCA Query and Retrieve (ODD) • RESTful: FHIR, JSON, MHD • Web Service • ... Pharmacy V3 QDA • RECON • DEN • DSG • ... Laboratory Aggregate results Dispatch queries CDA Radiology Pathology Master template CDA V3, V2 Nursing

  14. Linking to existing profiles • Important notes: • Actors / profiles in brown are not part of the QDA profile, but can be called from QDA using their respective transactions • It is up to the implementers which of the brown profiles are deployed • Important notes: • Query results from the Query Distributor can come from existing documents, but also from ‘live’ databases • It is up to the implementers which of the brown profiles are deployed 4. One report result 1. One report request Create Multi-Source Summary (ITI-xx) QDA QDA Results Aggregator QDA Query Distributor RECON HL7 CR Query QED DEN XCF DSG XDS MCV 3. Processing 2. Multiple queries (‘’any method’) XDS Q+R (ODD) ... RESTful Master template CDA V3, V2 Web Service QDA Configurator

  15. QDA parameters • Report ID • Requestor ID • Patient ID • Summaryformat • Collate • Reconcile • From-datetime • To-datetime • ToFormat • HL7 CDA • HL7 V2 message • HL7 V3 Message • XML document • Report ID • Requestor ID • Patient ID • Query ID • Target ID • Query Method • XDS Retrieve Document Set • XCA Query and Retrieve • HL7 Care Record Query • QED • RESTful: FHIR, JSON, MHD • Web Service • ANSI SQL • . ..? • Required document template (OID) • ‘Stitch’, collate to 1 doc • Use RECON to reconciliate • Message wrapper? Aggregate Request Distribute

  16. Remarks • QDA is a Profile that works as a Design Pattern. It is the centra part in a process that cn utilize a variety of other profiles, connecting them to a practical solution for a real-world process. • Some parts of the core functionality can be covered by existing profiles. However, some functionality is missing: • Receiving one report request, and then sending a number of preconfigured subqueries • Configuration of multi-source query summaries • Transforming information from different sources into one document • QDA uses preconfigurable links to different sources of information. However, in its current form, the profile links to a static sources. A Meta-index that points to only the sources that have relevant information of a certain patient would solve the problem of too many requests to different sources. • Look for synergy with RECON, DAF, MCV, XCF

  17. Your feedback?

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