Example+User+Story+–+Case+Control,+Vaccine+Efficacy







NOTE: //In this User Story the analysis of Query Result occurs at the Provider/Provider Organization and the Query Result is sent directly to the Information Requestor.//

In order to meet Stage 1 Meaningful Use Quality Measure requirements, an Eligible Provider enters in vaccination data as part of routine patient care into the EHR system (data source/aggregator ). This data is fed into a clinical information model/repository.

The Information Requestor creates and sends a query to determine the number of individuals over 50 who have and have not received the influenza vaccination (NQF 0041/PQRI 110), and whether or not they contracted the flu. The Information Requestor distributes the query directly to the appropriate Provider/Provider Organizations who act as their own Network Data Partner. After receiving the query request, the Electronic Health Record System utilizes the clinical information model to extract the data on those same individuals over 50. The query result is further refined to determine who has and who has not received the influenza vaccine and who amongst them has contracted the flu. At this time the Electronic Health Record System also checks for patient consent and creates a file or audit log of all patient level data used to create the query result.

The query result is fed into an intermediate data structure and a 2x2 observational analysis may be performed to determine the efficacy of the vaccination.



Table 1. Structure of 2x2 Analysis

The analysis results (the number of individuals over 50 who have and have not received the flu vaccine and the number of these respective individuals who contracted the flu) are structured to form the query result. The query result is then de-identified where applicable, reviewed, approved for distribution and distributed to the appropriate Information Requestors who collect and combine aggregated data from multiple sources.

Upon receiving the query result the Information Requestor refines the original query to confirm those patients diagnosed with flu and whether or not they experienced malaise, nausea, vomiting, diarrhea and/or high fever. The refined query request is then distributed to the appropriate Provider/Provider Organizations. After receiving the query request, the Electronic Health Record System utilizes the clinical information model to extract the data on those individuals over 50 who have and have not received the influenza vaccine. The data is further refined to determine who out of this pool has contracted the flu and reported malaise, nausea, vomiting, diarrhea and/or high fever. The extracted data is aggregated and fed into an intermediate data analysis. The query result is formed with the number of individuals who received the flu vaccine over the age of 50 and had flu like symptoms. The query result is then sent back to the appropriate Information Requestor.