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Metadata Analysis to the HIT Standards Committee. April 20, 2011. PCAST Report: Three Major Directions. 1.  Accelerate progress toward a robust exchange of health information.

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pcast report three major directions
PCAST Report: Three Major Directions

1. Accelerate progress toward a robust exchange of health information.

2. Establish a new exchange architecture with a universal exchange language (UEL) and interlinked search capabilities coupled with strong privacy and security safeguards. The exchange architecture will enable clinicians and patients to assemble a patient's data across organizational boundaries and facilitate population health.

3.  Establish an evolutionary transition path from existing installations to the new exchange architecture.

metadata requirement categories
Metadata Requirement Categories

Potential metadata elements are provided for the following categories:

  • Patient Matching
  • Provenance
  • Consent

For each element, standards that reference similar metadata have also been identified

  • “N” means no corresponding element
  • “Y” indicates that the standard defines an element similar to the corresponding metadata element.
    • “Y” includes optional elements
    • We did not evaluate syntax or structural requirements
patient matching background
Patient Matching Background

Get data on John Smith

  • Goal: Find all of a patient’s tagged data elements in multiple DEASs
  • Challenges
    • Bias towards false negatives
      • Privacy vs. Accuracy
    • Differences in name structure between cultures
    • Time sensitivity of name and address
    • SSN is a good identifier, but poses too many issues to be fully used

Searching Software




Jonathan Smith

DOB: 05-12-1948?

Jon Smith

DOB: 5/12/48?

No Results

Goal is to expose a subset of patient data that maximizes the relevance and completeness of the information returned.

provenance background
Provenance Background

Ordered by Dr. Smith 2/12/11

  • Goal: Determine the “who, what, when, where, why and how” of tagged data elements (TDEs)
  • Challenges
    • Tagged data element vs. content provenance
    • Many Health IT standards have pieces of provenance information, but they don’t capture the complete picture
    • “Full” provenance for TDEs is unlikely to be populated and expensive to maintain
  • Start with shallow provenance, increase over time

Performed at local hospital 2/14/11

Transferred to PCP Dr. Jones 2/15/11

provenance core metadata
ProvenanceCore Metadata

Provenance Stds


Healthcare Stds

consent background



from ModularComponents


  • Goal: Express what tagged data elements can be shared with a party in a situation
  • Challenges
    • Conceptual vs. concrete policy
    • Choosing correct granularity
    • Inadvertent disclosure of sensitive information
      • E.g., disclosing existence of an HIV test even if the result is not disclosed


Request +Content Tags


Data Elementswith ContentMetadata

Tagged DataElement(s)


Get data on Jon Smith

consent core metadata
Consent Core Metadata

Request Metadata

Policy Components



Adriane Chapman

Database Software Engineer

Gail Hamilton

Database Software Engineer

Jean Stanford

Information Systems Engineer

Stacie DeRamus

Healthcare Principal

Lisa Tutterow

Health ITProgram Manager

Andrew Gregorowicz

Software Systems Engineer

Marc Hadley

Software Systems Engineer

Peter Mork

Technical Advisor