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 firstname.lastname@example.org. 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. This list represents a sampling of the supplements published by the QRPH Technical Committee. Brief summary descriptions of the profiles are listed below. Detailed specifications of all QRPH profiles are contained at QRPH Technical Frameworks.
- 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 Detection and Intervention (EHDI) describes a family of profiles that help to assess, track, treat, and perform quality metrics initiatives related to newborn hearing.
- 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.
- Mobile Retrieve Form for Data Capture (mRFD) describes an exchange of context information that allows a seamless form launch and FHIR-based exchange of clinical data.
- 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 Co-Chairs:
Planning Committee: Lori Fourquet, e-HealthSign, LLC; Derek Ritz, ecGroup Inc.
Technical Committee: John Stamm, Epic; Laura Bright, LJB Consulting, Inc.