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

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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

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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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