Quality, Research and Public Health

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IHE Quality, Research and Public Health Domain (QRPH) addresses the infrastructure and content necessary to share information relevant to quality improvement in electronic patient care and health care records, improves the liaison between the primary care system and clinical research and it serves in cases where population base surveillance is needed. The three components addressing the different aspects of the QRPH domain have all in common the secondary or the repurposing of data.

  • Quality – Repurposing of data
  • Clinical Research – Secondary use of data
  • Public Health – Population base surveillance

The QRPH work enables the stakeholders to focus on the workflow cycle of queries for data and selection of population cohorts from within the clinical record. In addition, the QRPH incorporates the output from the query specification within the clinical system workflow to enable clinical decision support and defines profiles for adverse event reporting especially with reference to medication-related adverse outcomes.


It is sponsored by Health Information Management Systems Society (HIMSS) and Radiological Society of North America (RSNA) and manages the Quality Profiles and the Quality Technical Framework.

There are two committees. For details regarding activities of each, select the appropriate link below:


Timeline : 2009-2010 Development Cycle

The Timeline shows the main milestones of the development cycle, the Timeframe when they are typically expected to happen, and the actual date/time/location they have been Scheduled for this year.

Specific meetings and their agendas and minutes are generally listed on the page of the relevant Committee.

[All times in Central US time]

Timeframe Activity Scheduled Location
2010
Aug. Documents Published for Trial Implementation
July Public Comment Deadline
June Documents Published for Public Comment
2009
Dec. Select Final Profiles
Nov. QRPH Technical/Planning Committee Face-to-Face Meeting Nov 10-11 RSNA Headquarters, Oakbrook, IL
Oct. QRPH Planning Committee Face-to-Face Meeting Oct 5-6 RSNA Headquarters, Oakbrook, IL
Oct. QRPH Planning Webinar #4 (joint with PCC) Oct 1
11:00-1:00pm CT (Tentative)
 
Sept. QRPH Planning Webinar #3 (joint with PCC) Sept 29
3:00-5:00pm CT
 
Sept. QRPH Planning Webinar #2 Sept 25
10:00-12:00pm CT
 
Sept. QRPH Planning Webinar #1 Sep 23
1:00-3:00pm CT
 
Sept. Deadline for submission of new QRPH Profile proposals Sept 15
at 11:59 pm CT
 

Timeline : 2008-2009 Development Cycle

The Timeline shows the main milestones of the development cycle, the Timeframe when they are typically expected to happen, and the actual date/time/location they have been Scheduled for this year. Specific meetings and their agendas and minutes are generally listed on the page of the relevant Committee. 2008-2009 Timeline [All times in Central US time]

Timeframe Activity Scheduled Location
2010
Jan. Test implementations at Connectathon   Chicago
2009
Aug Documents Published for Trial Implementation Aug. 10
July. QRPH Technical Committee Face-to-Face Meeting - Resolution of Public Comments and Preparation of Documents for Publication Agenda July 13-17 RSNA Headquarters, Oakbrook, IL
June Public Comment Deadline
June Documents Published for Public Comment June 1
May. QRPH Technical Committee Face-to-Face Meeting - Completion of Documents for Public Comment Agenda May 4-8 RSNA Headquarters, Oakbrook, IL
Apr. European Union Connectathon April 20-24  
Apr. HIMSS 2009 April 6 - 9 Chicago, IL
Feb. North American Connectathon February 23 - 27 Chicago, IL
Jan. QRPH Technical Committee Face-to-Face Meeting Agenda January 26-29 RSNA Headquarters, Oakbrook IL
2008
Dec. Joint Planning/Technical Committee TConn to Select Final Profiles


Agenda QRPH Joint Planning/Technical TCon 22 Dec 2009

Dec 22 12:00 - 2:00 PM CST Tcon
WebEx Link
Nov. QRPH Technical Committee Face-to-Face Meeting

Agenda
Selected Profiles Detailed at:Quality, Research and Public Health Technical Committee

Nov 18-19 RSNA Headquarters, Oakbrook IL
Oct. QRPH Planning Committee Face-to-Face Meeting

Agenda
Minutes

Oct 20-21 Arlington VA HIMSS Office

Roadmap

The Quality Roadmap outlines goals and plans over the next 5 years. The Roadmap will be updated after the Quality, Research & Public Health Domain (QRPH) March 11-14, 2008 Technical Committee meeting.

Minutes

See the respective committee pages for agenda and minutes of each meeting or tcon.

Profile Selection Current Cycle 2008-2009

The following proposals have been evaluated by the Planning and Technical Committees. Final resolution is pending a Planning and Technical Conference Call on December 22, 2008 (see calendar for details).


2007-2008 Activity

The Quality, Research & Public Health Domain (QRPH) is currently focused on the workflow cycle of queries for data and selection of population cohorts from within the clinical record. The cycle begins with a query defintion that can be incorporated into the EHR to identify appropriate patients that represent the desired cohort, and identify expected interventions as well as exceptions that would exclude individuals from the cohort. Cohort selection and management should be enabled for concurrent management and analysis as well as for retrospective analysis. Methods for accessing patient-level clinical data to meet the requirements of the query were discussed in the framework reviewed in 2007 (Patient-Level Export of Quality Data <PEQD>). The 2008 work effort completed two profiles and one white paper.

The QRPH Domain continues to seek volunteers for participation in current work effort, change proposals to existing profiles, and recommendations for new activities. If you would like to participate, contact the QRPH Planning Committe or the QRPH Technical Committee.

IHE Quality, Research and Public Health Domain (QRPH): A Call for Participation

The Domain began under the sponsorship of the American College of Cardiology (ACC), the American Heart Association (AHA), the Healthcare Information and Management Systems Society (HIMSS), and the Radiological Society of North America (RSNA) as outreach to Clinician Communities to Discuss How to Incorporate Quality Guidelines into Electronic Health Record Interoperability. Its mission is to address the infrastructure necessary to share information relevant to quality improvement in electronic patient care and health care records. Beginning with a domain kickoff meeting April 11-12 2007 at the Four Points Sheraton, Chicago-O'Hare. The meeting focused on developing use cases to provide the basis for a Technical Framework to enable sharing of quality guidelines in electronic health record (EHR) applications and related systems.

Understanding the similarities for repurposing data for Quality, Research & Public Health, the Domain scope incorporates the broader vision. Clinical, demographic and financial information about individuals is used routinely in the process of providing clinical care directly to patients. Information gained through direct care processes provided to patients has significant value with respect to the monitoring of disease patterns for known clinical processes regarding incidence, prevalence and situational awareness, and to the identification of new patterns of disease not previously known or anticipated. Public Health requirements therefore, are met through the re-purposing of clinically derived data for analysis. Such data are subsequently incorporated within existing Public Health population analyses and programs for direct outreach and condition management through registries and locally determined appropriate treatment programs or protocols. Similarly, information about care processes delivered to patients is used to identify adherence to expected evidence-based clinical care protocols or guidelines to determine the processes and/or outcomes that determine the quality of care provided by individual clinicians or groups of clinicians. Much of the data required for quality analyses exists within the clinical patient record and, similar to the examples provided for Public Health, those data can be re-purposed for analysis. The protocols for subsequent management of clinicians and individual patients with respect to quality data are often addressed as performance improvement or performance management or disease management initiatives on the level of populations and for individual patient care. Research and clinical trials, likewise, require identification of patterns of clinical presentation and processes to identify individual patients and groups of patients appropriate to consider for inclusion in research protocols and for whom consent might be sought. Subsequent management, follow up and clinical information requirements require similar infrastructure and high level content gathering capabilities as identified in Quality and Public Health. Hence, there are significant similarities among Quality, Research & Public Health requirements for re-purposing of existing clinical data and the subsequent management of patients and clinical care providers. The issues of specifications for patient selection, and for individual and aggregate (summary) reporting of data, and for privacy and security constraints for re-use (or secondary use) of patient or clinician-derived data can best be managed in an IHE Domain specifically focused in this area. Such a domain also provides focus where Quality, Research & Public Health experts can collaborate and coordinate activities. Globally there is a need to gather and report on secondary data used in public health, clinical decision support and research to improve quality, efficiency and safety of patient care delivery.


Current sponsors include the American Heart Association (AHA), the Healthcare Information and Management Systems Society (HIMSS), and the Radiological Society of North America (RSNA).

Supporters and Endorsements

IHE Quality, Research & Public Health (QRPH) is supported or endorsed by the following organizations:

Committee Rosters

Committee Distribution Lists

Subscribe to the QRPH domain committee lists by visiting the Google Group sites linked below:


Change Proposals

The QRPH specific CP Process:

The following text explains what the process used by the QRPH commitee in processing submitted CPs. It is consistent with the general IHE CP process and is informative only.

  1. Submission into the Incoming Directory. This is typically done via an email to the QRPH Technical Committee co-chair in charge of CPs (currently Jason Colquitt) or by directly updating the directory if you have access to the ftp write password.
  2. First consideration by the committee. If CP is accepted it is given a CP #, assigned an editor, renamed to CP-QRPH-xxxx-00.doc and placed in Assigned Directory. If CP is rejected it is moved to Rejected Directory and submitter is informed of explanation for rejection. Likely reasons for rejection are: duplicate, merged, withdrawn or not enough information to understand the request. Rejected CPs can be resubmitted with more information for reconsideration.
  3. CP numbering is managed on the Change Proposal Master List page
  4. Committee works with editor to draft the CP. Versions are kept in Assigned directory and numbered -00, -01, -02, etc.
  5. Committee decides CP is ready for ballot. Latest version of CP is moved to Completed Directory and old versions are moved to Old-Versions Directory.
  6. Co-chair collects Completed CPs into a ballot. The Ballots Directory will be used for this.
  7. Ballot is released to the general community for voting
  8. Votes and comments are collected. All yes votes means the CP passed ballot and moved to Final Text Directory. No votes are resolved by the committee. Sometimes CP is withdrawn, sometimes NO voter changes to yes vote after explanations. CP may be updated in this process. If updates are insignificant (clarification only) the CP is considered passed. If updates are significant the CP is submitted for another ballot.

Also see: