Minutes QRPH Nov Nov 10-11 2009

Present:

Introductions.

Planning cycle, profiles that were recommended to the technical committee by the planning committee
The two committees have been combined in order to strengthen the domain.
This is the first joint committee meeting.
The task is to vote on profiles that will be pushed forward
The Public Health Metadata Registry & Vocabulary Services is an ITI profile and will be addressed in ITI. They have offered to contribute to 3 QRPH content profiles
RPE task force - RPE is coming into the first cycle of the Connectathon and it will require change. Landen Bain would like to have involved as many people as possible involved.
Agreement on the agenda and switching time slots to accommodate schedules.
Explanation of the process of voting

Overview of profiles EDHI - Terese Finitzo.

This profile describes the first encounter that the baby has with the healthcare provider.
The profile attempts to send the screening data to where it needs to go, and then to follow up if care is needed.
From a public health perspective this will improve the baby’s care.
Clinical surveillance monitoring - this is the ongoing monitoring that the baby needs to get for follow-up.
Data goes where it needs to go so that public health can intervene.
The time will be from birth to three years old. This proposal is based on the while paper that was written last year.
This is the construct that supports the IS 92 construct.

Redaction Services

The clinical research interoperability IS98 identified a gap.
CCD documents were sending to the clinical research systems.
There must be a way in order to fill in the forms without overpopulating the forms.
This profile can be used in order with Public Health in terms the vital statistics.
This can be used as a general purpose tool.
Can you use QED or XPath? XPath is more general.
This can also apply to the Quality part as well.
Cancer Registry can also use this profile. This is an infrastructure profile for QRPH. Will this need the ITI input?

Cancer Registry

Getting clinicians to report a cancer case to a Cancer Registry form Public Health in a formal, standard way.
This is being used in Canada.
This is a content profile.
Most of the data elements were mapped onto the CDA so the effort is limited.
CDC in order to bring the whole process together connecting cancer registries, and doctors’ physicians.
ASCO (American Society of Clinical Oncologists is interested in this project. Would like to use something similar to the PHIN VADS so that the vocabulary can be used. With regards to the PHIN VADS services, can they be used in a different way. CaDSR is another vocabulary services.
CIIC is used in HL7.
USHIK is working with HITSP.
There has to be a way described about who will manage the value sets. CDISC has a project that is called SHARE. There will be a vocabulary mapping the same way it is used in the research word and the clinical word.

Quality Report Document

Create the document (content creator).
NQF has the QDS elements defined. This will take their data elements and create the quality report. This is a CDA document which reports quality measures.
The next profile is to create the infrastructure so that this data can be extracted. The Quality Report Sharing profile we defines the infrastructure needed.

Public Health Case Reporting Workflow

Look at using the RPE profile. The white paper will be focusing on examples or reporting on the communicable diseases.
Can this use case be expended beyond the communicable diseases?
The list of public health scenarios should be listed. The use case is very specific to Hepatitis B. This is not a white paper.
This is a CP to RPE and not a white paper hence a smaller effort.
A very clear framework is needed. Need what is to be transacted. Content - definition of the data elements. New content: the instructions that need to be executed. Example: in a protocol (clinical research) find a patient between 25-35 etc. This is like a filter or a query (a case definition or the case criteria). Call up a knowledge base that has the data. The content is defined by this knowledge base.

Bottom line - cannot define every time the CDA form.

* EDHI

Presentation of the detailed proposal.
Cost reduction for the health care system.
Question about the scope. Proposing three use cases. Collaborate with four states.
Make a change proposal to the CP and then use this as basis for the New Born Screening.
Wait until December to make the revision to the white paper.
Harry suggests submitting proposal right away since the process it will take longer.
Clinical surveillance vs Public Heath surveillance component.
The Hearing Screening reports are not specified in what format they will be.
How do we aggregate data?
Specify a patient level surveillance not an aggregated data.
Content profiles, confusion about the transactions mentioned (HL7 v2.5 vs HL7 v3.0).
The aggregate reports must remain out of scope since there are no standards and no transactions for it.
What is the content in the reports? This is multiple content profile.
There is only one document going from the hospital to public health.
The public heath will send a care plan back to the HCP and a document with aggregated data.
There are two documents at the individual level and one aggregated document going back to the health care provider.
This needs to be scoped out since it is not very clear.

Redaction Services

Gap identified in the HITSP work IS98, drawing on RFD. The discrete data is not available directly since the data is in the observation entry but there is a need to know the section template.

There are two ways to do this:

Create a document specific for each case. This is too cumbersome (thousands of studies, different protocols).
Leverage CCD in a general way. The question of pre-population arises. What percentage of pre-population can you achieve? Some of the data cannot be reached. Some of the data will not be in the pre-populated form and the main researcher will have to do this manually. Push CCD to the limit, push CRD and add to this combination according to the needs. This is not a reduction spec this is a “what I am allowed to see” spec.
- Vital statistics is interested in this profile as well.
- There will be at least a document that is time stamped.
- Use brand new names to start with and then it might converge.
- Form receiver does not play in this, take it out.
- The word redaction might be misleading or not. This is positive because of the protection of data. Can this be called extraction?
- Take RFD actors and then rename them. Can CRD be used?
- Add the redaction option to RFD that it will add the document ID and the template ID to the retrieve form Transaction in RFD and to have an option as not to send pre-populated.
- Landen will change the format of the detailed format.

Cancer Registry

Quality Report Document

No international feedback, hard to get it.
HITSP specifications will meet the vendor’s need but this would be nice to address from an IHE International point of view.
Can we wait a year?

Quality Report Sharing

Core RPE profile that is high level and then
Can be a similar solution with the Public Health and Research cases
Address the RPE task force
Combine with the solution that we came up with the Public Health Case Reporting.

Conclusion: all work pushed forward for the committee plus the maintenance items.

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