ONC launches project to query EHRs for population health data

By Mary Mosquera
11:19 AM

The Office of the National Coordinator for Health IT (ONC) has launched its Query Health project to come up with the standards and services to enable providers to send information requests and questions about population health to a variety of places where it is held, primarily certified electronic health records.

Providers will distribute their requests through network data partners, who will deliver the query through a standard clinical information model and then securely return the results to the requester.

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The goal is for healthcare providers to be able to ask the data questions about population and public health, quality and research and learn from the information, said Dr. Farzad Mostashari, the national health IT coordinator, in announcing the project on Sept. 6.

With the establishment of certified electronic health records (EHRs) reaching critical mass and an emerging electronic infrastructure, it is possible for the first time to consider broad uses of distributed population queries and other complex data activities.

“The opportunity for us is to really turbo-charge our understanding of population health, performance and quality based on this critical mass of health information technology, an understanding for proactive patient care, to deliver insights for quality improvement,” he said. Distributed queries can also help to assure that performance measures are consistently applied across different types of settings and that treatments that are most effective are followed.

With this capability, large and small providers will be able to conduct population analyses and calculate quality measures for populations for clinical and payment strategies.

The project resides in ONC’s Standards and Interoperability Framework organization, which is creating a wiki community of interested individuals to focus on clinical aspects, technology and business requirements to drive Query Health forward.

During the summer, ONC conducted a scan of how a variety of organizations already use population distributed query for public health monitoring, research and quality, said Rich Elmore, Query Health coordinator. For example, one approach simplifies and integrates performance reporting and decision support in a population continuity of care record, popCCR, which makes analytics more portable and separate from large health IT solutions.

To move forward, participants who shared their experience with distributed query agreed that there was a need to reduce the variation in clinical concepts and coding and for management organization coordination. “That was really more difficult to get right across organizations than the technology,” Elmore said.

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ONC will use existing data that is in electronic health records and other clinical records as a starting point for analytics and enable standards and services that can provide consistency across data sources, said Dr. Doug Fridsma, director of ONC’s office of standards and interoperability.

Over the coming year, Query Health will also rely on some of the same practices used in coming up with the Direct Project’s secure messaging protocol last year, such as “developing running code, providing it in open source so that we can enable pilots to happen and for people to be able demonstrate the value of their ideas,” he said.

An example of the kind of activity where healthcare professionals need to ask questions of many sources may be in public health to identify who has contracted the flu and who has not. This could support one of the meaningful use quality measures, which is to report the number of patients over the age of 50 who have received the flu vaccine, and from the comparative effectiveness perspective, the information could indicate how well the vaccine worked.

The ability to perform a distributed query into EHRs will “make it possible that every physician in the country has as their tool the analytics that even the more sophisticated organizations have,” Fridsma said.