Multi Query Dispatch and Aggregate MQDA Work Item ProposalFebruary 10-14th, Vienna IHE F2F meeting

Vincent van Pelt, Albert-Jan Spruyt (Nictiz)Mark Sinke, Walco van Loon (ForCare)

Business needs

· Healthcare professionals need up-to-date summaries containing the most current medical information about the patient

· These summaries are made by aggregating information (“building blocks”) from different sources that each generate a different part of the information

· These different systems use different query methods

· The information from these systems may be created on the fly (from their database), or they can be already existing documents

· The information building blocks coming from different systems need to be aggregated into one summary

-> Need for a profile that can take care of complex multi-query creation and result aggregation

Use Cases· On-Demand Medication Overview

· Prescriptions · Dispensations · Allergies, contra-indications· Relevant diagnoses · Relevant lab values

· On-Demand Patient Summary· Derives building blocks from multiple systems· ‘Blue button’ creation?

· On-Demand Emergency Care Summary· Combined information from emergency call center, ambulance, Emergency department, ICU

· On-Demand Integrated Care Overview· Combined information from PCP, dietician, physiotherapist, laboratory, etc.

· On-Demand Laboratory List· Aggregated overview of laboratory results from different dates and locations

MQDAMulti Query Distribute and Aggregate

Generic profile for the on-demand creation of multi-source summaries and aggregated reports

Process :

1. One report request

2. Multiple queries to several data-sources

3. Processing and aggregation

4. One report result

Functionalities

Report request: MedSumm 1

ReportID

QueryID

Query Method

Target OID Result Template OID

Query parameters

MedSumm 1 MedPrescr HL7 Query

PCP A PRE …

MedSumm 1 MedPrescr HL7 Query

Hospital B PRE …

MedSumm 1 MedDisp HL7 V2 Pharmacy X DIS …

MedSumm 1 MedLabData QED Laboratory Y LAB-x …

MedSumm 1 MedDiagData XDS EMR-Hospital Z DIAG-x …

PatientSumm 1 DiagData … … … …

PatientSumm 1 LabData … … … …

Query result 1

Query result 2

Query results ....

Report result: MedSumm 1 Aggregation

XDS

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

Register On-DemandDocument Entry (ITI-61)

XDS + ODD

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

On-DemandDocument Source

Register On-DemandDocument Entry (ITI-61)

XDS + ODD (+ persistent storage)

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

On-DemandDocument Source

Provide and Register Document Set (ITI-41)

Register On-DemandDocument Entry (ITI-61)

XDS + ODD + ?

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

On-DemandDocument Source

Provide and Register Document Set (ITI-41)

Not defined how this profile creates the on-demand document

Register On-DemandDocument Entry (ITI-61)

MQDA

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

On-DemandDocument Source

MQDA Content Creator

ITI-X: Create Multi-Source Summary

Provide and Register Document Set (ITI-41)

Register On-DemandDocument Entry (ITI-61)

MQDA

Provide and Register Document Set (ITI-41)

Retrieve Document Set (ITI-43)

RegisterDocument Set (ITI-42)

Registry StoredQuery (ITI-18)

Document Registry

DocumentSource

DocumentRepository

DocumentConsumer

On-DemandDocument Source

QDA Content Creator

ITI-X: Create Multi-Source Summary

Provide and Register Document Set (ITI-41)

• HL7 Care Record Query• QED• RESTful: FHIR, JSON, MHD• Web Service• XDS Retrieve Document Set• XCA Query and Retrieve• XCF• ANSI SQL• ...

EHR

Pharmacy

Laboratory

Radiology

Pathology

Intra-andCross-enterprise

Nursing

Deploying existing profiles

(Query Distributor)QED

RESTful: FHIR, JSON

Web service

HL7 V2 Query

HL7 CR Query

ANSI SQL

...

Content Creator

(Query Aggregator)

RECON

DSG

MCV

...

DEN

1. One report request

2. Multiple queries 3. Processing

1. One report result

ITI – X Create Multi-Source Summary

QDA parameters

• Report ID

• Requestor ID

• Patient ID

•Summaryformat• Collate• Reconcile

• From-datetime

• To-datetime

• ToFormat• HL7 CDA• HL7 V2 message• HL7 V3 Message• XML document

Request • Report ID

• Requestor ID

• Patient ID

• Query ID

• Target ID

• Query Method• XDS Retrieve Document Set• XCA Query and Retrieve• HL7 Care Record Query• QED• RESTful: FHIR, JSON, MHD• Web Service• ANSI SQL• . ..?

• Query string (OID)

• Required document template (OID)

Distribute • ‘Stitch’, collate to 1 doc

• Use RECON to reconciliate

• Message wrapper?

Aggregate

Remarks· Some parts of the functionality can be covered by existing profiles. However, some functionality is

missing:

· Receiving one report request, and then sending a number of preconfigured subqueries

· Configuration of multi-source query summaries

· Transforming information from different sources into one document

· It is a recognizable profile that solves a real-world demand

· Find synergy with RECON, DAF, MCV

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