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Query Health Clinical Work Group:

Clinical Element Data Dictionary (CEDD) Activity

The Clinical Elements Data Dictionary Group will no longer be meeting. For updates on the Query Health project, please attend the Technical Workgroup meetings on Thursdays. Click the Technical WG button above for meeting details.

Overview

The Query Health CEDD is intended to serve as a "view" of the clinical data that is needed to support a distributed query. In this way, it is not intended to be a new clinical information model, but a representative clinical view of the data needed to support various queries as defined in the Query Health Expanded Analysis user story and Query Health Generic Use Case. It serves as a clinical data dictionary that describes the data elements, the relationships of these data elements, possible datatypes for the elements, and how they are used in support of a specific query (for example, usage in a computation or measure). It is important to clarify that the primary focus of this working group in the short term is to define this data dictionary, to be followed in the short term by the physical representation of the data dictionary (using various possible approaches, including SQL, NOSQL, or other types of representations). The work of developing the physical representation will be a joint effort with the Technical Working Group.

The immediate approach of the working group for the month of December will focus on the following short-term steps (also outlined in the visual below):

Review of existing technical foundation data models (with a focus on clinical content)
  • SHRINE (i2B2)
  • Mini-Sentinel (PopMedNet)
  • hQuery

Introduction of the Clinical Data Dictionary Crosswalk - to be discussed in the November 30 Clinical Working Group meeting. This crosswalk has several purposes:
  • Determine areas of reuse for the Query Health Technical Foundation (evaluated using a clinician/researcher focus)
    • Example – where are commonalities among the different technical approaches and their data?

  • Determine gaps, where is there no data defined to support the Expanded Analysis user story or the Generic Use Case
    • Example - where is data missing in the current technical foundation approaches that would be needed in support of a query

Formulating Data Dictionary
  • Develop initial documentation and possible supporting models to provide to the Technical Working Group. Focus will be on representing the data dictionary in a clinically-relevant and research-oriented format. This may include development of data models using standard data modeling notation to support implementers
  • Includes alignment with the Clinical Concept Mapping Approach (under development in the Clinical Concept Mapping Sub-Working Group)

Schedule subject matter expert discussions on clinical information models that may be of interest
  • In alignment with the Clinical Concept Mapping work, determine how best to reuse existing clinical information models, and to ensure the data dictionary work is not in conflict with existing clinical information models.

The tangible outcome we are looking for in the short term, in support of getting to Query Health Pilots:
  • A clinically-relevant, reusable and simple data dictionary with supporting documentation and models that can be used to support the work of the Query Health Technical Foundation.
  • Alignment with the underlying Query Health Technical Foundation standards
  • Physical manifestation of the data dictionary to support the development of running code by the Technical Working Group
  • Alignment with the clinical concept mapping approach under development in the Clinical Concept Mapping sub-working group
  • Alignment with work in the Clinical Information Modeling Initiative (CIMI) to the degree that is necessary in support of the S&I Framework Query Health Initiative

What we are NOT trying to do:
  • Build a brand new clinical information model with its own syntax that is not clinically relevant or easily understandable.
  • Reuse a single clinical information model and its syntax - this would imply a "choice" of a standard, which is not the intent of this activity
  • Create a new standard or approach that is NOT in alignment with the Query Health Technical Foundation

Works in Progress

Name of the Artifact
Description/Purpose of the Artifact
Current Status
Query Health CEDD Crosswalk
A clinical element data dictionary describing data elements, relationships, applicable data types, and how they are used in support of a specific query.
Open
Query Health CEDD_Version 0.1.docx NEW!
Documents the needed data to support distributed queries in a variety of formats, and provides working examples to assist implementers and vendors in structuring source data to support query and query results.
Open

Reference Materials

These reference materials serve as potential sources of further detail into the work of developing a Query Health CEDD:
Reference Material
Reference Description
CMS EMS 1997.pdf
1997 Documentation Guidelines for Evaluation and Management Services provided by Lindsey Hoggle & Roberto Beraja
Transitions of Care Clinical Information Model Version 1.5 (link)
The Transitions of Care (TOC) Clinical Information Model (CIM) is intended to serve as a logical overlay and neutral
representation of the data needed to support care transitions. The value proposition inherent in the CIM is that it
provides a view for clinicians into the type of data needed to support each care transition, and gives implementers
and vendors an idea of how to store and exchange that data. The TOC CIM is intended to be a logical view of the
common data model that underlies all care transition information. In practice, it will manifest itself as physical data
within an organization engaged in transitions of care.
hQuery Data Model (jpeg)
  • Standard information model exposed to queries
  • Independent of backing data source (C32, CCR, RDBMS, …)
  • Enables generic queries regardless of backing data source
  • Tuned for ease of querying
NQF Quality Data Model 2011 Draft Version (link)
The Quality Data Model (QDM) is an “information model” that clearly defines concepts used in
quality measures and clinical care and is intended to enable automation of electronic health record (EHR) use.
It provides a way to describe clinical concepts in a standardized format so individuals (i.e., providers, researchers,
measure developers) monitoring clinical performance and outcomes can clearly and concisely communicate
necessary information.
Mini-Sentinel Common Data Model Version 1.1 (link)
The Mini-Sentinel Common Data Model (MSCDM) is a standard data structure that enables Data Partners to run
standardized programs against data stored locally at their sites. This work is based off of PopMedNet.
SHRINE Data Reference Guide (link)
This reference guide describes the SHRINE Core Ontology, including...
  • Terminology
  • Composition
  • Source systems and maintenance schedules
  • Data descriptions
GE/Intermountain Clinical Element Models (CEM) (link)
The Clinical Element Models have been developed by GE and Intermountain Healthcare to help move the industry
towards computable models. Dr Stan Huff has been one of the primary contributors to these models. These can be
browsed at http://intermountainhealthcare.org/CEM/Pages/LicenseAgreement.aspx
Federal Health Information Model (FHIM)
The FHIM is a model of healthcare data developed for the FHA partner agencies. The FHIM project seeks to
develop a common Logical Information Model or Computationally Independent Model (CIM).
Clinical Quality and Vocabulary Task Force Workgroup.pdf
The Clinical Quality and Vocabulary Task Force Workgroup proposes a list of recommendations that specifically address the 23 categories of clinical concepts [data elements] as defined and proposed by the Quality Data Model version 3.0 (QDM). (Provided by Thompson Boyd <thboyd2@gmail.com>)
PCIP_QueryHealth_PilotProjectProfile_20120112.doc
New York City Department of Health and Mental Hygiene & New York State Department of Health Pilot Project Profile
Clinical Information Model (CIM) Activity Scoping Statement.docx
Lays out a high-level scoping statement for the Query Health Clinical Information Model (CIM), including target outcomes, scope of the CIM, and key short-term and long-term activities.

Workgroup Members

WG Chair: Michael Buck
ONC Representative: Erik Pupo
Name
Organization
Contact Information
Role
Erik Pupo
Deloitte
erpupo@deloitte.com
ONC Contractor Lead
Nagesh Bashyam
Harris
nbashy01@harris.com
ONC Support