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IHE Quality Domain February 26, 2008. IHE Quality Domain – Year 1. IHE Quality Year 1 Participation HIMSS, RSNA, American Heart Association Sponsorship Leadership by clinical committee members, vendors Technical Framework (Patient-Level Export of Quality Data – PEQD)
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IHE Quality Domain – Year 1 • IHE Quality Year 1 • Participation • HIMSS, RSNA, American Heart Association Sponsorship • Leadership by clinical committee members, vendors • Technical Framework (Patient-Level Export of Quality Data – PEQD) • Year 2 – Evaluate commonalities for data repurposing, expand scope to Quality, Public Health and Research
Form Filler Key Actors from Other Profiles Retrieve Form for Data Capture (RFD) Patient Admin Management (PAM) Query for Existing Data (QED) Retrieve Into for Display (RID) Cross-Enterprise Document Sharing (XDS) Cross-Enterprise Document Reliable Interchange (XDR) IHE Quality Domain: PEQD Monitoring Agent / Destination Agency Document Recipient # Provide and Register Document Set [ITI-14] Form Manager Form Receiver Form Archiver Provide Notification of New Measure Definition [reserved] # Submit Aggregate Data [reserved] # Submit Form [ITI-35] # Retrieve Form [ITI-34] Document Source # Archive Form [ITI-36] Analyzer / Aggregator Actors Grouped for Options Patient Encounter Consumer Clinical Data Consumer Display Document Consumer Document Source Report Creator # Patient Encounter Management [ITI-31] • Query Data [PCC 1 - 6] $ Retrieve Specific Info for Display [ITI-11] $ Retrieve Document [ITI-17] $ Provide and Register Document Set [ITI-14] $ Submit Report [Reserved] $ Retrieve Document for Display [ITI-12] $ Query Registry [ITI-16] Care Delivery Information System Actors` Form Filler Patient Encounter Source Data Repository Information Source Document Registry Document Repository Enterprise Report Repository
Year 2 – Technical Framework • Selected Profiles • Structured Quality Measure Definition and Import • Drug Safety Content
Year 2 – Technical Framework • Mission • Expand international participation and reach out to Public Health and Research organizations • Expand scope and rename as Quality, Public Health and Research Domain • Reach out to Clinical Decision Support community
Harmonization of Specification Efforts Quality Measure <QualityMeasureDocument> <CODES> <CONCEPT NAME="diabetes" LANG="I9" <CONCEPT NAME="HbA1c" LANG="LOINC" </CODES> <LOGIC> <DENOMINATOR> <CONCEPT NAME="age" VALUE="18" UNI <CONCEPT NAME="diabetes"/> </DENOMINATOR> <EXCLUSION> <CONCEPT NAME="PCOS"/> </EXCLUSION> <NUMERATOR> <CONCEPT NAME="HbA1c"/> </NUMERATOR> </LOGIC> <QualityMeasureDocument> QMD Quality Report Patient 1 QRD <ContinuityOfCareDocument> <IDENTIFICATION> <FIRSTNAME="Jane"/> <LASTNAME="Doe"/> </IDENTIFICATION> <CLINICAL> <LABORATORY> <CONCEPT NAME="HbA1c" VALUE="8.6" <CONCEPT NAME="LDL" VALUE="165" DA </LABORATORY> <PROBLEMLIST> <CONCEPT NAME="Diabetes" DATE="10/ <CONCEPT NAME="Hyperlipidemia" DA </PROBLEMLIST> <MEDICATIONS> <CONCEPT NAME="Atorvastatin" <CONCEPT NAME="Aspirin" DA <CONCEPT NAME="Metform </MEDICATIONS> Patient 2 Patient n <ContinuityOfCareDocument> <IDENTIFICATION> <FIRSTNAME="John"/> <LASTNAME="Smith"/> </IDENTIFICATION> <CLINICAL> . . . </CLINICAL> </ContinuityOfCareDocument> CCD <ContinuityOfCareDocument> <IDENTIFICATION> <FIRSTNAME=". . ."/> <LASTNAME=". . ."/> </IDENTIFICATION> <CLINICAL> . . . </CLINICAL> </ContinuityOfCareDocument> CCD XDSMS patient data sharing standard (HL7/CDA) “diagnosis” from common data elements (HITEP) structure & terminology standard selection (HITSP) defined by measure developer organization (MDO) and endorsed by consensus including proper formatting (NQF) logic content (Collaborative) logic representation (HL7/IHE) Diagram Courtesy of Dan Rosenthal, National Quality Forum (IHE/HITSP)
