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Metadata Analysis to the HIT Standards Committee

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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Metadata Analysis to the HIT Standards Committee

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  1. Metadata Analysisto theHIT Standards Committee April 20, 2011

  2. 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.

  3. 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

  4. 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 DEAS 2 DEAS 3 DEAS 1 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.

  5. Patient MatchingCore Metadata

  6. 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

  7. ProvenanceCore Metadata Provenance Stds Other Healthcare Stds

  8. ConsentBackground PatientPreferences Policy:Assembled from ModularComponents PolicyServer • 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 ReleaseDecision Request +Content Tags DEAS Data Elementswith ContentMetadata Tagged DataElement(s) Request Get data on Jon Smith

  9. Consent Core Metadata Request Metadata Policy Components ContentMetadata

  10. Acknowledgements 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

  11. Discussion Discussion

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