Charles Boicey, RN and Enterprise Analytics Architect for Stony Brook Medicine shares how RDF Triples can reconcile data from multiple and disparate sources to unlock great insight.

1. INTEROPERABILITY EXERCISE,
TRIPLE STORE & ONC
INTEROPERABILITY ROAD MAP
Charles Boicey, MS, RN-BC, CPHIMS
Enterprise Analytics Architect
Stony Brook Medicine
Stony Brook University

2. Interoperability Exercise

3. DSRIP
• 8 billion dollar grant (Medicaid waiver) from CMS
to NY State
• 25% reduction over five years in avoidable
hospitalizations and ER visits in the Medicaid and
uninsured population
• Collaborative effort to implement innovative projects
focused on
• System transformation
• Clinical improvement
• Population health improvement

4. Uninsured + Medicaid
Members
Medicaid Members Data from DSRIP 2012; Uninsured data from ACS 2012 5 Year Estimate
n = 387,290
Geographic Concentrations in Western, Central and Eastern
Suffolk

5. 5 YEAR GOALS
• Create integrated Suffolk County care delivery
system for 387K lives anchored by safety net
providers
• Engage partners across the care delivery
spectrum to create a countywide network of care
• After five years, transition this network to an ACO
which will contract with insurance providers on an
at risk basis

6. Suffolk PPS Organizational Structure
for exchange of clinical data and alerts for patient visits through e-HNLI
Stony Brook
Medicine
Suffolk PPS HIE
(SB Clinical
Network IPA, LLC)
Health
Systems
Hospitals
Community
Health
Centers
Behavioral
Healthcare
Providers
Skilled
Nursing
Facilities CHHA’s/
LTHHC
Physician
Groups
Health
Homes
Community-
Based
Agencies
Pharmacies
Those not part of the Stony
Brook Medicine Network
Other
Healthcare
Providers
Develop-mental
Disability
Providers
Suffolk
county RHIO
(e-HNLI)
Jim Murry, Charles Boicey

7. Suffolk Care Colaborative IT Architecture
Suffolk County Providers
Suffolk county PPS Master Patient Index (MPI)
Suffolk county PPS Health Information Exchange (HIE)
E-HNLI RHIO (HIE)
Suffolk County PPS Patient Portal
Stony Brook Medicine
Suffolk County Big Data Platform
Suffolk County PPS Population Management Tools
EMRs or clinical Information System
EMRs or clinical Information
System
eForms Patient
Wellness
Alerts Mobile Monitoring Patient Education Clinical
Records
Collaboration
Registries Care Plans Workflow Med Adherence Mobility
Predictive Analytics Event Engine Structured Data Financial Data Legacy Data
Machine Learning NLP Unstructured Data Wearables Data Social Data
Anomaly Detection Rules Device Data HL7/CCD Open Data
ClinicalDataforPatientCare

8. R
H
I
O
Interface Engine
Hl7, CCD, CCDA, FHIR, XML, JSON
Payors
Population Management
Platform
DSRIP
Provider Systems
N>200
Consent Query
SBM
HIE
SBM
EMRs
nonSBM
EMRs
Clinical Claims
Clinical
Claims
Clinical
Clinical
Clinical
View
Clinical
View

9. Semantic Web – RDF Triple Store

10. First a Couple of Definitions
Semantic: Study of Meaning
Semantic Information System for Healthcare: Is a semantic
web system based on healthcare ontology
Ontology: common vocabulary, common understanding

11. Why RDF Triples?
• Semantic Interoperability
• Sending data that can be understood by sender and receiver
• Benefits of Healthcare Information Technology Depend on
Interoperability
• Interoperability Difficulties Between Systems
Shortliffe, Cimino, 2006

12. Resource Description Framework
Ogbuji, 2013

13. Diseases
hasSymptom
isSymptomof
Class
Class
Ogbuji, 2013

15. ONC Interoperability Roadmap
• Public Comment Period Ends
• April 3, 2015 @ 1700 EDT
• http://www.healthit.gov/policy-researchers-
implementers/interoperability
• Publications
• Connecting Health and Care for the Nation: A Ten Year Vision to
Achieve an Interoperable Health IT Infrastructure (13 pages)
• Connecting Health and Care for the Nation: A Shared Nationwide
Interoperability Road Map Draft Version 1.0 (166 pages)

16. Interoperability Defined
The Office of the National Coordinator for Health IT is
responsible for advancing connectivity and interoperability
of health information technology (health IT). ONC follows
the IEEE definition of interoperability as the ability of
systems to exchange and use electronic health information
from other systems without special effort on the part of the
user.

17. Learning Health System

18. 10 Year Plan Guiding Principals
• Build Upon Existing Infrastructure
• One Size Does Not Fit All
• Empower Individuals
• Leverage the Market
• Simplify
• Maintain Modularity
• Consider Current Market and Support Multiple Layers of
Advancement
• Focus on Value
• Protect Privacy and Security

19. Use Cases Over 10 Years
3 Years
Primary Care Providers
exchange patient
information with
specialist during the
referral process
6 Years 10 Years
Individuals manage
information from their
own electronic devices
and share that
information seamlessly
across multiple
electronic platforms as
appropriate (health care
providers, social service
providers, consumer-
facing apps and tools,
etc).
Primary care providers and
authorized researchers are
able to understand how well
controlled diabetic patient
population’s glucose levels
(i.e., A1C values) are and
how often those patients
have been hospitalized
based on standardized
information from multiple
sources.

20. Building Blocks
1. Core Technical Standards and Functions
2. Certification to Support Adoption and Optimization of
Health IT Products and Services
3. Privacy and Security Protections for Health Information
4. Supportive Business, Clinical, Cultural and Regulatory
Environment
5. Rules of Engagement and Governance of Health
Information Exchange

21. Interoperability Training Courses
• Transitions of Care
• Lab Exchange
• Patient Engagement
• Public Health Measures
http://www.healthit.gov/providers-
professionals/interoperability-training-courses

22. Life is short,
Build Stuff
that

23. Contact Information
Charles Boicey
charles.boicey@stonybrookmedicine.edu
(631) 444-3791
@N2InformaticsRN