Bridging Data Models in Health Care With a Novel Intermediate Query Format for Feasibility Queries: Mixed Methods Study

• Published in: JMIR medical informatics Vol. 12; p. e58541
• Main Authors: Rosenau, Lorenz, Gruendner, Julian, Kiel, Alexander, Köhler, Thomas, Schaffer, Bastian, Majeed, Raphael W
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 14.10.2024
• Subjects: Data exchange; Data models; eHealth Infrastructures; Electronic Health Records; Feasibility; Feasibility Studies; Germany; Health care; Health Information Exchange; Health Information Interoperability; Humans; Informatics; Information Storage and Retrieval - methods; Interoperability; Methods and Instruments in Medical Informatics; Mixed methods research; Ontologies, Classifications, and Coding; Original Paper; Quality standards; Queries; Research Infrastructures and Registries; Secondary Use of Clinical Data for Research and Surveillance; Standards and Interoperability; Structured Query Language-SQL; Syntax; User interface; Germany; development; eligibility criteria; implementation; portals; query; JSON; interoperability; FHIR; cohort definition; develop; informatics; queries; healthcare interoperability; feasibility; interoperable; clinical research; portal; intermediate query format; ontologies; ontology; CQL
• ISSN: 2291-9694; 2291-9694
• DOI: 10.2196/58541

To advance research with clinical data, it is essential to make access to the available data as fast and easy as possible for researchers, which is especially challenging for data from different source systems within and across institutions. Over the years, many research repositories and data standards have been created. One of these is the Fast Healthcare Interoperability Resources (FHIR) standard, used by the German Medical Informatics Initiative (MII) to harmonize and standardize data across university hospitals in Germany. One of the first steps to make these data available is to allow researchers to create feasibility queries to determine the data availability for a specific research question. Given the heterogeneity of different query languages to access different data across and even within standards such as FHIR (eg, CQL and FHIR Search), creating an intermediate query syntax for feasibility queries reduces the complexity of query translation and improves interoperability across different research repositories and query languages. This study describes the creation and implementation of an intermediate query syntax for feasibility queries and how it integrates into the federated German health research portal (Forschungsdatenportal Gesundheit) and the MII. We analyzed the requirements for feasibility queries and the feasibility tools that are currently available in research repositories. Based on this analysis, we developed an intermediate query syntax that can be easily translated into different research repository-specific query languages. The resulting Clinical Cohort Definition Language (CCDL) for feasibility queries combines inclusion criteria in a conjunctive normal form and exclusion criteria in a disjunctive normal form, allowing for additional filters like time or numerical restrictions. The inclusion and exclusion results are combined via an expression to specify feasibility queries. We defined a JSON schema for the CCDL, generated an ontology, and demonstrated the use and translatability of the CCDL across multiple studies and real-world use cases. We developed and evaluated a structured query syntax for feasibility queries and demonstrated its use in a real-world example as part of a research platform across 39 German university hospitals.