Scalable and High-Throughput Execution of Clinical Quality Measures from Electronic Health Records using MapReduce and the JBoss® Drools Engine

AMIA Annu Symp Proc. 2014 Nov 14:2014:1864-73. eCollection 2014.

Abstract

Automated execution of electronic Clinical Quality Measures (eCQMs) from electronic health records (EHRs) on large patient populations remains a significant challenge, and the testability, interoperability, and scalability of measure execution are critical. The High Throughput Phenotyping (HTP; http://phenotypeportal.org) project aligns with these goals by using the standards-based HL7 Health Quality Measures Format (HQMF) and Quality Data Model (QDM) for measure specification, as well as Common Terminology Services 2 (CTS2) for semantic interpretation. The HQMF/QDM representation is automatically transformed into a JBoss(®) Drools workflow, enabling horizontal scalability via clustering and MapReduce algorithms. Using Project Cypress, automated verification metrics can then be produced. Our results show linear scalability for nine executed 2014 Center for Medicare and Medicaid Services (CMS) eCQMs for eligible professionals and hospitals for >1,000,000 patients, and verified execution correctness of 96.4% based on Project Cypress test data of 58 eCQMs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms
  • Centers for Medicare and Medicaid Services, U.S.
  • Electronic Health Records*
  • Humans
  • Meaningful Use
  • Medical Informatics Applications*
  • Quality Indicators, Health Care*
  • United States