Three pilot projects have illustrated the potential of the Query Health initiative to handle population-level health queries across diverse clinical systems, according to new research in the Journal of the American Medical Informatics Association. The Office of the National Coordinator for Health IT launched the initiative, a public-private partnership, in 2011 to develop standards and services to enable distributed, secure, standards-based population health measurement.
The idea is that data is more secure in its original location; individual organizations process queries and disclose only the minimum necessary information to answer queries. Responses are aggregated, then sent to the researcher. This federated approach has been used successfully in pilots at public health departments in New York City and Massachusetts and with the U.S. Food and Drug Administration's post-market safety surveillance activities.
The projects hinged on an open-source architecture for secure, standards-based clinical queries. Existing standards were used wherever possible. It involved developing a platform-neutral query language, a Query Envelope standard for secure transport of queries and results, a 'result language' and other standards.
The New York City Department of Health and Mental Hygiene is using the Query Health platform to add practices and health information exchange organizations that are using a variety of health information systems to its health surveillance program. It runs parallel to a proprietary system that more than 650 primary care practices use to respond to queries.
It tested the Query Health system last October, analyzing the data from the New York statewide health information exchange (SHIN-NY). Full production release is planned for 2014. Using both systems will allow comparisons of the Query Health accuracy, speed, stability and capabilities.
The three-month FDA project used similar architecture, but placed the PopMedNet technology--used for secure query distribution and response--in the cloud.
The Massachusetts pilot was technical only--focused on fully implementing the Query Envelope standard--to demonstrate its flexibility and granular security control. It's still being used.
Though the pilots were successful, the authors say improved cross-platform data normalization is needed. The pilots will inform more work in the area, they say.
Interoperability woes continue to bedevil the best of health data-sharing plans, as the Defense and Veterans Affairs departments can attest.
Despite this initiative, a recent Government Accountability Office report criticized the U.S. Department of Health & Human Services for lack of specific strategies to help accelerate data exchange.
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