IHE Quality, Research and Public Health
The IHE Quality, Research and Public Health (QRPH) domain addresses the information exchange and electronic health record content standards necessary to share information relevant to quality improvement in patient care, clinical research and public health monitoring.
The QRPH domain was formed in 2007 to address use cases related to repurposing of clinical data for these critical "secondary" uses. Globally there is a need to
gather and report on secondary data used in public health, clinical decision support, quality measure reporting and research to improve the quality,
efficiency and safety of patient care delivery.
Clinical, demographic and financial information is routinely gathered and used
in the process of providing clinical care. This information has significant
value to public health agencies for monitoring disease patterns of known
clinical processes (including incidence, prevalence and situational awareness)
and for identifying new patterns of disease. Such data may be used to develop
population analyses and programs for direct outreach and condition management
through registries and locally determined appropriate treatment programs or
protocols.
Similarly, information about care processes delivered to patients can be used
to identify adherence to expected evidence-based clinical care protocols and to
assess outcomes and quality of care provided by individual clinicians or groups
of clinicians. Much of the data required for quality analysis exists within the
clinical patient record and can be repurposed for analysis. The protocols for
subsequent management of clinicians and individual patients with respect to
quality data are often addressed as performance improvement or disease
management initiatives.
Research and clinical studies, likewise, require identification of patterns of
clinical presentation to select patients for inclusion (with consent) in
research protocols. Subsequent study execution , requires infrastructure and detailed
content gathering capabilities similar to those required by quality initiatives
and public health.
The QRPH domain addresses specifications for patient selection, individual and
aggregate date reporting, and privacy and security constraints for re-use of
patient information, enabling experts in health quality, research and public
health to collaborate and coordinate their activities.
The current sponsors of the QRPH domain are the Healthcare Information and
Management Systems Society (HIMSS), and the Radiological Society of North
America (RSNA).
Information on committee membership and current activities is available on the QRPH wiki page or by
contacting the domain secretaries at qrph@ihe.net. Use the links below to download the
technical framework and supplement documents published by the committee, view or subscribe to committee mailing lists (via Google Groups)
and view a detailed calendar of committee activities.
IHE Quality, Research, and Public Health Profiles
The QRPH
Technical Committee has published the following profile supplements. Detailed
specifications of these profiles are contained in the QRPH Technical Framework page. Brief summary descriptions of the profiles are listed below.
- Birth and Fetal Death Reporting (BFDR) describes the
content and format to be used within the pre-population data part of the
Retrieve Form Request transaction from the RFD.
- Birth and Fetal Death Reporting-Enhanced (BFDR-E) profile provides a means to capture and communicate information needed to report births and fetal deaths for vital registration purposes. BFDR-E builds upon the earlier Birth and Fetal Death Reporting (BFDR) Profile that utilizes actors and transactions defined in the ITI Retrieve Form for Data Capture (RFD) Profile to capture structured data using digital forms.
- Clinical Research Document (CRD) describes
content pertinent to the clinical research use case required within the IT
Infrastructure Retrieve Form for Data-Capture (RFD) pre-population parameter.
- Clinical Research Process Content (CRPC) specifies content, which is appropriate to help automate the sharing of information among systems during the clinical research process using the transactions from the Retrieve Process for Execution (RPE) profile. Using the transactions from the Retrieve Process for Execution (RPE) profile, CRPC will improve the recruitment for, setup, and performance of clinical studies.
- Data Element Exchange (DEX) leverages the concept of a metadata registry to add mapping metadata to an annotated data capture form at the point of form design instead of the exchange of data instances.
- Drug Safety Content (DSC) describes content pertinent to
the drug safety use case required within the IT Infrastructure Retrieve Form
for Data-Capture (RFD) pre-population parameter.
- Early Hearing Care Plan (EHCP) assists with the
early detection, documentation of and intervention for hearing loss by enabling
electronic communication of care plan content and instructions available to all
authorized providers of care as jurisdictionally directed by the Public Health
Early Hearing Detection and Intervention (EHDI) Program.
- Early Hearing Detection and Intervention (EHDI) defines a new Hearing Plan of Care document (HPoC) which replaces the earlier Early Hearing Care Plan (EHCP) and defines the message content for a hearing screening device to communicate results to a receiving system.
- Family Planning (FP) describes the use of ITI’s RFD to report encounter-level family planning clinical visits. The profile describes the basic data elements that are needed to report quality metrics, a new Family Planning Pre-pop document in alignment with PCC conventions, and maps the data elements to CDA (consisting of the Header, Pregnancy History, Pregnancy Status Review, Coded Vital Signs, Coded Social History, Coded Care Plan, and Coded Results sections).
- Healthy Weight (HW)
captures and communicates information for managing and monitoring healthy
weight among clinical and public health surveillance systems.
- Maternal Child Health-Birth and Fetal Death Reporting (MCH-BFDrpt) defines the EHR content that may be used to pre-populate and transmit birth and fetal death information to vital records systems for vital registration purposes.
- Newborn Admission Notification Information (NANI)
describes the content needed to communicate a timely newborn admission
notification to public health to be used by Early Hearing Detection and
Intervention (EHDI) screening programs.
- Physician Reporting to a Public Health Repository-CancerRegistry (PRPH-Ca) defines the data elements to be retrieved from the EMR and
transmitted to the cancer registry or to a healthcare provider.
- Quality Measure
Execution-Early Hearing (QME-EH) describes the content needed to
communicate patient-level data to electronically monitor the performance of
early hearing-loss detection and intervention (EHDI) initiatives for newborns
and young children.
- Redaction Services (RSP) redacts data from a document in a
user's current application to meet the requirements for exporting to an
external system.
- Research Matching (RM) publishes research process
definitions to EHR systems to match patients and investigators with appropriate
research studies.
- Retrieve Process for Execution (RPE) enables a
healthcare provider to access a process definition, such as a research protocol
and to execute automated activities, without leaving an EMR session.
- Structured Data Capture (SDC) profile utilized the IHE Retrieve Form for Data Capture (RFD) profile for retrieving and submitting forms in a standardized and structured format. This supplement is based on the work of the US Office of the National Coordinator for Health Information Technology, Standards & Interoperability (S&I) Framework SDC Initiative.
- Vital Records Death Reporting (VRDR) defines a Retrieve Form
for Data Capture (RFD) content profile that will specify derivation of source
content from a medical summary document. by defining requirements for form
filler content and form manager handling of
the content.
QRPH Committee Calendar
QRPH Committee Co-Chairs:
Planning Committee: Lori Fourquet, e-HealthSign, LLC; Laura Bright, LJB Consulting, Inc.
Technical Committee: John Stamm, Epic; Derek Ritz, ecGroup Inc.