Query+Health+Technical+Approach+-+Consensus+Page

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**Balloting is closed.**
__** Summary: **__ The Query Health Technical Approach documents the decisions of the Technical WG activities to date and identifies the starting point for developing implementable specifications based on standards along with a robust reference implementation. The actual specifications and the reference implementation development activities have not yet started, however the artifacts produced will be available for consensus as they are developed. This Call for Consensus is to ensure we have consensus to proceed in the direction documented by the Technical Approach.


 * **Full Name** || **Organization** || **Endorsement**
 * (Yes/ NO)** || **If No, what can be changed to make it Yes?** ||
 * Adele Allison || SuccessEHS, Inc. ||  ||   ||
 * Adrian Gropper || HealthURL ||  ||   ||
 * Ahmed Ghouri MD || Anvita Health Inc. ||  ||   ||
 * Alice Leiter || National Partnership for Women & Families || Yes ||  ||
 * Amy Walker || HealthIT Plus, a business division of QSSI ||  ||   ||
 * Andy Gregorowicz || MITRE ||  ||   ||
 * Aneel Advani || Indian Health Service ||  ||   ||
 * Anil Kumar || CNSI ||  ||   ||
 * Anne Kling || MITRE ||  ||   ||
 * Anne Marie Priddy || Coastal Connect HIE ||  ||   ||
 * Anthony LaRocca || Apixio ||  ||   ||
 * Arien Malec || Relay Health || Yes with reservations || Would vote "NO" if this were a final technical approach, vote "Yes" with the understanding that this is getting us to testing. I like the overall architectural framework, need to see the following to get to a production Yes:
 * 1) Real specification for transport/privacy framework (instead of "Use PopMedNet")
 * 2) Simplify and/or green HQMF and QRDA
 * 3) Address how to express (even if "by PDF document that gets translated to code by R/SAS programmers") advanced queries ||
 * Arnon Rosenthal || MITRE ||  ||   ||
 * Barry Rhodes || CDC / DHQP ||  ||   ||
 * Bilal Alqudah || HACNet labs at SMU ||  ||   ||
 * Bob Rogers || Apixio ||  ||   ||
 * Brandon Weinberg || Individual ||  ||   ||
 * Brian Ahier || Gorge Health Connect, Inc. ||  ||   ||
 * CARL FARMIS || DISCOVERTURE HEALTH SOLUTIONS ||  ||   ||
 * Cassondra Fredriksen || FairWarning Inc || Yes ||  ||
 * Chris Kim || Cal eConnect ||  ||   ||
 * Charlie Ishikawa || International Society for Disease Surveillance ||  ||   ||
 * charlotte weaver || Gentiva Health Services ||  ||   ||
 * Christopher Forrest, MD, PhD || Children's Hospital of Philadelphia ||  ||   ||
 * Christopher G Chute || Mayo Clinic ||  ||   ||
 * Corey Spears || McKesson ||  ||   ||
 * Cynthia Bero || Partners HealthCare ||  ||   ||
 * Dan Konson || CareEvolution, Inc. ||  ||   ||
 * David A. Stumpf, MD, PhD || OptumInsight ||  ||   ||
 * David Harlow || The Harlow Group LLC ||  ||   ||
 * David McCallie MD || Cerner ||  ||   ||
 * Deborah Leyva || Nuvon ||  ||   ||
 * Didi Davis || Serendipity Health, LLC || Yes with comments || Reasonable starting point, but I would expect that we would continue to evolve the approaches specified based on real world experience of implementation in the POC. Agree with reservations expressed by some of the others who know much more than me. We need to improve and provide feedback to the existing standards. ||
 * Doron Gutkind || LINTECH ||  ||   ||
 * Douglas A Gentile || Allscripts ||  ||   ||
 * Edward Glynn || Bon Secours Health System ||  ||   ||
 * Elizabeth Casey Halley || MITRE ||  ||   ||
 * Eric Heflin || Medicity ||  ||   ||
 * Erin Fitzsimmons || Angel eCare ||  ||   ||
 * Eugene Fievitz || SDI Health ||  ||   ||
 * Eva Powell || NPWF ||  ||   ||
 * Floyd Eisenberg || National Quality Forum ||  ||   ||
 * Frank Davison, CISA, CRISC || University of Tennessee Health Science Center ||  ||   ||
 * Fred Rahmanian || Siemens || Yes || Agree with overall approach. ||
 * George Cole || Allscripts || Yes || We share concerns expressed by others about QRDA but feel the overall approach still merits a Yes vote. ||
 * George Thomas || HHS ||  ||   ||
 * Georjean Parrish || All Healthcare Research & Resource Consulting ||  ||   ||
 * Gloria Nunez || OptumInsight ||  ||   ||
 * Gora Datta || CAL2CAL Corp ||  ||   ||
 * Greg Sharp MD || Ideal Family Healthcare ||  ||   ||
 * Ifti Qadir || Virginia Information Technologies Agency (VITA) ||  ||   ||
 * Imran Chaudri || Apixio ||  ||   ||
 * Ioana Singureanu || Eversolve ||  ||   ||
 * Itara Barnes || American College of Rheumatology ||  ||   ||
 * Jacob Reider, MD || Delmar Family Medicine ||  ||   ||
 * James St.Clair || HIMSS ||  ||   ||
 * Jay Srini || SCS ||  ||   ||
 * Jeffrey Brown || HPHCI\HMS || Yes || Share same concerns re HQMF and QRDA (expressed nicely by Marc H and Michael B). Given our need to **quickly** create a working POC, simple is not only better but required to meet our goals. ||
 * Jennifer Cockle || VHA, CHIO, Standards and Interoperability ||  ||   ||
 * Jeremy Davis || Mount Auburn Cambridge, IPA ||  ||   ||
 * Jim Kretz || Center for Mental Health Services of SAMHSA ||  ||   ||
 * Joel T. Ryba || Healthcare Information Xchange of NY ||  ||   ||
 * John T. Donnelly || IntePro Solutions ||  ||   ||
 * John Haughton MD, MS || Covisint || yes || worried about complexity and verbosity of QRDA to test concepts of queryhealth out of the gate. If we run into issues on pilots, suggest one of the native formats from i2b2 or popmednet or other that has proven effective gets used, at least on a test basis. ||
 * John Klimek || NCPDP ||  ||   ||
 * John Moehrke || GE HEALTHCARE ||  ||   ||
 * John Sharp || Cleveland Clinic ||  ||   ||
 * John Williams Loonsk || CGI Federal ||  ||   ||
 * John Williams || Health-ISP ||  ||   ||
 * Joseph A Reid || Emergint Technologies, Inc. ||  ||   ||
 * Joycie Hunter || Cal eConnect, Vulcan Enterprises LLC || Yes ||  ||
 * Jyoti Pathak || Mayo Clinic ||  ||   ||
 * Kathleen Connor || Baycliffe Strategies Inc ||  ||   ||
 * Karen Nielsen || Siemens ||  ||   ||
 * Keith W. Boone || GE Healthcare || Yes ||  ||
 * Khaled El Emam || University of Ottawa / Children's Hospital ||  ||   ||
 * Kim Nolen || Pfizer ||  ||   ||
 * Laura J. Miller || National Quality Forum ||  ||   ||
 * Leslie M Tompkins || US FDA / CDRH ||  ||   ||
 * Lin Wan || Axolotl Corp. (now OptumInsight) ||  ||   ||
 * Lindsey Hoggle || Health Project Partners,LLC ||  ||   ||
 * Lynne Gilbertson || NCPDP ||  ||   ||
 * Marc Hadley || MITRE || Changed to yes || Vote changed to yes based on addition of note 2 to final summary: "//Neither HQMF nor QRDA category III can be used “as is” for Query Health. We will investigate the feasibility of revising these specifications to make them suitable for distributed population query execution. Success of this investigation is a baseline requirement to use modified versions of HQMF and QRDA category III as the basis for queries and their results.//"

Original Comments: We are concerned with the choice of specifications for query and results formats: - HQMF (Query Format) - While we recognize the value of portions of the HQMF (specifically the metadata and data criteria sections) we don't believe the current expression of measure logic is amenable to automated computation. - QRDA Category III (Results Format) - Again, we recognize the value of portions of QRDA but believe that category III is not currently mature enough to be endorsed by Query Health. In both cases we feel that it is premature for Query Health to endorse these specifications, even using the current qualified language. We recommend changing the technical approach document to endorse development of (unnamed) XML standards for query format and results with only informative references to HQMF and QRDA category III as possible source of inspiration. This will leave our options open until we are sure that a particular specification will meet our needs. Note we are not discouraging continued experimentation with these specifications, only recommending that we don't commit to them at this stage. ||
 * Marinus Moelker || Mountain Medical Technologies ||  ||   ||
 * Mario Laszczak || STEMSOFT Software Inc. ||  ||   ||
 * Mark Frisse || Vanderbilt University ||  ||   ||
 * Mary Sheridan || Independent ||  ||   ||
 * Michael Buck || Primary Care Information Project in the New York City Department of Health and Mental Hygiene || Yes || I have similar concerns along with John Haughton and Marc Hadley that HQMF and QRDA might not be a perfect fit but with the potential to use the native formats such as that already used by i2b2 that is a good fallback in case the modifications to those standards don't work out well during the pilots. More concerned about HQMF that QRDA as the result set coming back should be fairly simple. ||
 * Michael M. Talley || Southeast Michigan Health Exchange || Yes ||  ||
 * Michael Ryan || SAP ||  ||   ||
 * Michael Sawczyn || Ohio Health Information Partnership ||  ||   ||
 * Michael Trebatoski || SAIC ||  ||   ||
 * Micky Tripathi || Massachusetts eHealth Collaborative ||  ||   ||
 * Mike Spraggins || Seton Hospital ||  ||   ||
 * Mitra Rocca || FDA ||  ||   ||
 * Mr. Tracy Rue || Quality Health Network ||  ||   ||
 * Nancy Lush || Lush Group, Inc ||  ||   ||
 * Nicholas J. VanDuyne || New York eHealth Collaborative ||  ||   ||
 * Nicole Cook, PhD, MPA || Nova Southeastern University, Masters of Public Health Program ||  ||   ||
 * Nikolay Lipskiy || CDC/OSELS ||  ||   ||
 * Norman Joseph || Mountain Medical Technologies ||  ||   ||
 * Paul Bleicher, MD PhD || Humedica ||  ||   ||
 * Paul Goldman || Practice Communication, LLC ||  ||   ||
 * Paulo Machado || Health Innovation Partners ||  ||   ||
 * Peter Mork || MITRE ||  ||   ||
 * Robert A. Greenes || Arizona State University ||  ||   ||
 * Robert Barker || NextGen Healthcare ||  ||   ||
 * Robert Dieterle || Enablecare ||  ||   ||
 * Robert McClure, MD || Apelon, Inc || Changed to Yes || Vote changed to YES based on addition of explanitory statements in final summary, in particular those noting approach to Privacy/Patient Data consent.

Original comments: 1) It is not clear how data consent for privacy requirements will be met. It may be that the assumption is that consent will already be managed outside Query Health, but that seems a small box to put this in. So I'd like to see at least a "stub" to indicate that an approach that is more than opt-in/opt-out will be dealt with in a reasonable place within the model. 2) The Data Element Model is thin at best. I understand that in many ways the content reflected here is a stub for future details but I would expect a more robust alignment with some of the exiting standards (openEHR Archetypes, vMR, QDM, even a future-tense reference to the CIMI work just starting out. 3) I suspect that a more complex query model will be required to support "typical" quality queries. There is ongoing interest in melding Gello into HQMF. Perhaps Keith has solved some of the more immediate needs but I suspect a more robust HQMF formalism will be required to do meaningful work. Yet, as a start, I'm in support of using HQMF (and QRDA III). ||
 * Robert Stephenson II || CSAP/SAMHSA/HHS ||  ||   ||
 * Ronald Ranauro || College of American Pathologists ||  ||   ||
 * Sarianne Gruber || SG Healthcare Analytics ||  ||   ||
 * Saul A. Kravitz || MITRE ||  ||   ||
 * Scott Chapin || MedPlus || Yes ||  ||
 * Sean Nolan || Microsoft Health Solutions || Yes! ||  ||
 * ShaMika Williams || Sage Healthcare || Yes ||  ||
 * Shawn Murphy || Massachusetts General Hospital ||  ||   ||
 * Shawn Wiese || Healthcare Managment Systems ||  ||   ||
 * Sheila Woodhouse, MD || Sentikon Consulting, and Sentikon Technologies ||  ||   ||
 * Sri Koka || Techsant Technologies LLC || Yes ||  ||
 * SRINI KRISHNAMOORTHY || DISCOVERTURE HEALTH ||  ||   ||
 * Srinivas Velamuri || Telligen || Yes ||  ||
 * Stan Norton || Humedica ||  ||   ||
 * Stephen Beller, PhD || National Health Data Systems, Inc. || Yes || I changed to Yes after offline conversation w/ Dragon, because I now realize that the last few sentences in section 4 provide the flexibility for diverse novel "overlay" implementations that adhere to the Query Envelope Specifications, Query Format Specifications, Query Result Specifications and the Query Health Data Element Specifications. ||
 * Steve Felt || Greenway Medical Technologies ||  ||   ||
 * Steve Rushing || Georgia Tech || Yes ||  ||
 * Susan Brink, DrPH || ConsentSolutions, Inc ||  ||   ||
 * Susan Fenton || Texas State University ||  ||   ||
 * Susan Nedza MD || HealthyCircles, LLC ||  ||   ||
 * Taha Kass-Hout || CDC ||  ||   ||
 * Teresa Black || Alere Health ||  ||   ||
 * Teresa Oates RN, MSN || HMS, INC. ||  ||   ||
 * Terri Ripley || Centra ||  ||   ||
 * Teresa Strickland || NCPDP || Yes ||  ||
 * Thomas P. Caruso || Biomedical Informatics Think Tank ||  ||   ||
 * Thompson H. Boyd, III, M.D. || Hahnemann University Hospital ||  ||   ||
 * Thomson Kuhn || American College of Physicians ||  ||   ||
 * Tim Richardson || Medical Arts Rehabilitation, Inc. ||  ||   ||
 * Urmimala Sarkar, MD, MPH || University of California, San Francisco Division of General Internal Medicine, San Francisco General Hospital, Center for Vulnerable Populations ||  ||   ||
 * Vassil Peytchev || Epic || Yes - see comments || Seems to be a reasonable starting point, as long as there are further opportunities along the way to revise any of the approaches specified here based on practical experience. Agree with some of the reservations expressed by others. Do not agree with suggestion to try to create new standards, rather improve existing ones as gaps are identified. ||
 * Vincent Lewis || GSI Health ||  ||   ||
 * Virginia Lorenzi || The NewYork-Prssbyterian Hospital ||  ||   ||
 * Vishnu Vyas || Apixio ||  ||   ||
 * Will Ross || Redwood Mednet ||  ||   ||
 * William Reiter || HealthShare Montana ||  ||   ||
 * Xiaohui Zhang, Ph.D. || Scientific Technologies Corp ||  ||   ||

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