2020-10-30 CoP Meeting Notes

Date: October 30th, 2020

Time: 12pm ET

Attendees (93)

Non-MITRE (77)

MITRE (16)

Action items

• CoP November 2020 Meeting: November 20th from 12-1pm ET – Register Here
• Reach out to Anthony DiDonato via email @adidonato@mitre.org if you would like to participate on future calls!

Planned Agenda Topics

Community Welcome – Anthony DiDonato (CodeX)

CodeX Use Case Updates – Steve Bratt (CodeX)

mCODE++ Extraction Framework Overview – Zeshan Rajput (MITRE)

Epic’s Involvement in mCODE – Ryan Bernard (Epic)

Meeting Minutes

Anthony DiDonato, mCODE CodeX Community Lead, kicked off the meeting with an overview of the CoP, mCODE, CodeX and with announcements.

Steve Bratt, the HL7 FHIR CodeX Project Lead, welcomed attendees and provided an update on CodeX. Updates to Confluence site reviewed. FHIR Shorthand Tool reviewed. Registry Reporting use case is now active.  

mCODE++ Extraction Framework Overview – Zeshan Rajput (MITRE):

• “use case zero” as in it support the majority of use cases in mCODE collection
• Extraction framework is open source and freely available
  • On GitHub – link provided in slides linked on confluence
• Why have an extractor when mCODE is a published standard?
  • It takes time, commitment, resources to implement such standards
    • We want to make adoption as straightforward as possible
    • Realize the interoperable benefit of mCODE today, not tomorrow
  • Started testing extraction work with Endpoints for Cancer Clinical Trials use case
    • Data captured in routine course of receiving clinical care
    • Behind scenes make this data available for research purposes
    • The extractor allows for accessing this data
  • Extractor also leveraged in ICAREdata study technical approach
    • Extractor grabs data from EHR and brings it into FHIR standard that mCODE supports
      • Delivers FHIR content as message up to research infrastructure
    • ICAREdata Reference Architecture (RI)
      • Extractor as part of architecture provides access to data
        • References library of services to return in mCODE format
      • Two versions of extractor
      • CSV flat file version
        1. Easiest to implement and use
        2. All EHR systems can leverage
      • Epic App Orchard version
        1. More robust in capability and ease of use
      • High level architecture of extractor provided in slides
      • mCODE extractor coverage
        • See slides for diagram highlighting mCODE elements supported
        • Continuing to expand to include all of mCODE
      • Future directions
        • Expand coverage of mCODE (started with low-hanging fruit)
        • Work with vendors to implement API-enabled versions
        • Build/borrow support for just-in-time queries for mCODE
      • You’re invited to get involved
        • Download and play with the CSV version (GitHub)
        • File an issue
        • If you know Node.js, opportunity to contribute directly

Epic’s Involvement in mCODE – Ryan Bernard (Epic):

• 54% of medical records in US use Epic
• Why involved in Epic?
  • Incentives
    • Expand customer base in Cosmos
      • Every organization that contributes data to Cosmos, has access to the full Cosmos community dataset
      • By participating in mCODE can optimize data submission and standardization
    • Clinical workflows
    • Data exchange
  • Original interest in mCODE came from Cancer Data Summit and work with ASCO/CancerLinQ
• Current integrated support workflow

1) Epic customer hears about mCODE

2) Directs to MITRE and Alliance

3) Epic builds and supports new workflows

1. Resources made available

• MITRE supports questions about mCODE standard
  1. App Orchard supports Epic data in mCODE format
• Resulting in
  • Better connection of mCODE to existing or future Epic customers
  • Better supporting avenues
  • Creation of data extraction app (as Zeshan emphasized)
  • Better Epic end user support

Q&A

Q: Is the API version of the extractor also available via GitHub?

A: No, because the API version for Epic does use some proprietary calls, we’ll be making it available via Epic’s App Orchard Dev Forums. It will still be freely available, you just have to have access to App Orchard.

Q: What should epic customers be doing in anticipating using extractor?

A: Depends on how far you are on mapping, web services, etc. The services we use are available through App Orchard, utilizing FHIR and non-FHIR based services, but adheres to same client ID. If you have a system that can run Node.js, then you should be good to go if APIs are in place. If using CSV extractor, it’s only a matter of having capabilities to export reports in Epic (through reporting workbench, clarity, or other means).

Q: How best can the community stay up to date with Epic-MITRE progress?

A: Go to user web (referenced in presentation, see slides)

Q: Regarding APIs the extractor utility makes use of, is there a comprehensive list?

A: Can make available yes, please reach out if interested.

Q: If interested in mCODE, how should Epic users reach out through Epic?

A: Follow process on slides. Reach out to your Epic administrators and representatives, and we’ll make sure to get the ball rolling on your involvement in mCODE.

Q: How best to get involved in ICAREdata?

A: Reach out to Keri Reardon or others listed on the ICAREdata confluence site – also available on last month’s presentation by Keri.

Q: Are there version controls on the mCODE schema?


A: Yes if go to mCODE IG can view under “History” tab