Translating clinical quality measures for queries proves complex

Massachusetts General Hospital computer scientists claim some success in translating between the Health Quality Measures Format (HQMF) and Informatics for Integrating Biology and the Bedside (i2b2) though the work has been time consuming and complex.

The paper, published at Journal of Medical Internet Research, describes a translator between the two XML languages. HQMF is a standard for expressing clinical quality measures. Creating tools to handle queries in clinical databases will grow in importance with Meaningful Use stages 2 and 3, the authors say.

The analytical database i2b2 is part of the Office of the National Coordinator's Query Health platform to move toward this goal. Children's Hospital Boston CIO Dan Nigrin spoke with FierceHealthIT about the role of i2b2 as part of its predictive modeling efforts. It also was part of a presentation (available online) at a symposium by the Indiana Clinical and Translational Sciences Institute Accessing Technology Program.

The translator described in the JMIR paper is configured for diagnoses, labs, procedures, medication administration events, and the demographics in SHRINE (age, gender, language, marital status, and race and ethnicity), though other data is supported through a configuration file. It is open source and available from the Query Health repository.

Two Query Health pilot projects using the translator are under way, one allowing the New York State Department of Health to create custom HQMF queries and execute them at i2b2 sites throughout New York. The second, at Beth Israel Deaconess Medical Center, connects i2b2 to the Food and Drug Administration's Mini-Sentinel network, allows the FDA to send custom HQMF queries to i2b2 sites.

The paper, however, notes the massive amount of work to achieve the gains that have been made and that much more work remains to be done.  They note, too, that running very complex queries could tax even powerful servers.

The National Quality Forum and several health IT organizations came up with the HQMF standard in 2009 to automate EHR-enabled quality reporting. "Through standardization of a health quality measure's structure, metadata, definitions and logic, the HQMF looks to provide consistency and unambiguous interpretation," the organizations said at the time.

To learn more:
- find the research
- check out the symposium

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