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Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
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SAFTINet Overview
 What is SAFTINet?
 Funding
 Partners and collaborators

Information Technology Infrastructure
 Distributed network based on TRIAD technology
 Observational Medial Outcomes Partnership (OMOP) Common Data
Model
 ROSITA and TRIAD node
 Data Extracts
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Data Use
 Use of ROSITA for population management, quality improvement
 Use of the network for research and comparative reporting
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Data Governance
Next Steps for SAFTINet and AppNet
What you can do
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
Who is SAFTINet?


A network of stakeholders interested in improving health care delivery and outcomes of
underserved populations
What is SAFTINet?


A practice-based research network and distributed data network with a distributed
database of clinical and claims data collected during routine care, to support both
research and quality improvement
SAFTINet Research and Quality Improvement Goals
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
Improve health care quality and value, and reduce health disparities, in low income
patients with chronic conditions who receive care in public safety net clinics, by
generating evidence that will inform health policy, health services delivery, and practice
at the point of care
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

AHRQ (American Recovery and Reinvestment Act 2009): Scalable
Distributed Research Networks for Comparative Effectiveness
Research
 Develop a distributed data network that collects and links data from
multiple and different healthcare delivery settings
▪ Clinical data from electronic health records (EHR)
▪ Medicaid claims data
 Demonstrate capabilities for conducting methodologically rigorous
Comparative Effectiveness Research (CER)
▪ Capability for enhanced data collection (e.g., patient-reported outcomes)

R01; PI: Lisa Schilling, MD, MSPH
 Initial funding for infrastructure development: 9/30/2010 – 9/29/2013
 Enhancement and Sustainability: 9/30/13 – 3/31/15
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
COORDINATING
CENTER
University of
Colorado School
of Medicine:
Director: Lisa
Schilling, MD
MSPH
PARTNERS
Partner Type
LEADERSHIP
DARTNet Institute
Partner practice-based research network (PBRN)
Deborah Graham,
MSPH
Wilson Pace, MD
Bi-State Primary Care Association
Partner network (clinical and claims data from 8
Vermont FQHCs)
Katherine Simmons,
MBA, MPH
Cherokee Health Systems
Safety net health care provider in Tennessee
Parinda Khatri, PhD
Colorado Community Managed
Care Network (CCMCN)
Partner network (clinical and claims data from Salud
and MCPN)
Jason Greer, BA
Metro Community Provider
Network (MCPN)
Safety net health care provider in Colorado
Alicyn Kaiser, PA-C,
MMSc
Safety net health care provider in Colorado
Maria de Jesus Diaz,
PhD
Salud Family Health Centers
Denver Health & Hospital Authority
Fletcher Allen Health Care
LA Community Health Resource
Network
Safety net health care provider in Colorado
Safety net health care provider in Vermont
Arthur Davidson, MD,
MSPH
Adam Buckley, MD
Partner PBRN (Clinical data from CHAP)
Lyndee Knox, PhD
Community Health Alliance of
Pasadena (CHAP)
Safety net health care provider in California
Grace Floutsis, MD
AppNET
Partner PBRN (clinical data from 5 FQHCs)
Fred Tudiver, MD
Ohio State University
Academic/Technical Partner
Philip Payne, PhD
University of Vermont
Academic Partner
Rodger Kessler, PhD
Technology infrastructure: Multi-node
Web Portal
Queries and
Data Transfers
Internet
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
Data Type
Examples
Person
Patient demographics
Medications
SNOMED codes
Encounters
Provider of record, date and place of service
Diagnosis
ICD-9 codes
Procedures
CPT codes
Observations
Vital signs, lab results
Costs
Paid claims
Cohort Membership
Clinical trial participation
Death
Date of death
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
FQHC1
FQHC2
FQHC3
FQHC4
FQHC5
FQHC6
FQHC7
FQHC8
CINA CDR
CINA CDR
CINA CDR
CINA CDR
CINA CDR
CINA CDR
CINA CDR
CINA CDR
XML
XML
XML
XML
XML
XML
XML
XML
ROSITA
Payer
Database
(Medicaid, BCBS, etc)
Clear Text
PHI
TRIAD
Limited
Dataset
OMOP V4
Web Portal
Firewall
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
Firewall
Secure Network
Queries and
Data Transfers
Internet
Practice Technical Requirements
 Install hardware and software on Practice network
(PC or VM)
 Create access to EMR database
 Practice must be able to create a new user login to the
EMR dBase
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Establish remote access to SAFTINet PC / VM
Set up EMR UI and user log in on SAFTINet PC / VM
Establish ability to pass files securely to ROSITA
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Our responsibilities (may not apply in all cases)
 Establish / create data connectors to EMR database
 Map identified data elements for import into CDR
 Testing / Validation of identified data elements in CDR
 Create automated secure data upload from Practice to CDR
 Create XML output for import into ROSITA
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Practice responsibilities
 Contract execution
 Identify IT and Clinical / EMR documentation liaison
 Perform activities defined under Technical Requirements
 Serve as a resource for assisting with location of data elements
understanding documentation patterns, if needed
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

ROSITA-based queries
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Single or multiple FQHC, linked clinical & claims data
Fully identified patient-level raw data
ROSITA administrator prepares reports as desired
SQL and analytic skills needed
Report writing within ROSITA
 JasperReports
 Current reports focused on data quality assessments
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Access restricted to personnel with appropriate
permissions
Collaborate to identify additional reporting needs and
corresponding technology enhancements
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Queries to the AppNet and other TRIAD
nodes
 Single or multiple nodes
 Limited dataset of patient-level raw data (requires
IRB/DUA for research, access to others’ nodes)
 Counts
 Quality metrics

Access restricted to those with TRIAD
accounts, with appropriate permissions
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Comparative Reporting and Benchmarking
 DARTNet Institute Practice Performance Reports
▪ Practice-level data in charts showing network-wide
performance statistics (e.g., percent of patients at goal
for blood pressure control)

Comparative Effectiveness Research
 Analytic data sets to test relationships among
different types of treatments, services, service
delivery models and health outcomes
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Master consortium agreement (MCA)
 Describes the terms and conditions under which Consortium
Members will participate in a network to permit the transfer,
use and disclosure of data to a network-enabled database.
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Data use agreements (DUAs)
 A legally binding agreement between parties (e.g., contractor,
private industry, academic institution, other Federal
government agency, or state agency), when an external entity
requests the use of Protected Health Information in the form of
a Limited Data Set.

Service Level Objectives (SLO)
 Defines roles, responsibilities and objectives for adoption and
maintenance of SAFTINet technology and security
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]
Introduction to Practice / IT contact to discuss technical
installation (determine feasibility, potential hardware /
software costs, etc)
 If technical install feasible:
Execute DARTNet Agreements

 CINA software license agreement (through DARTNet Institute
as software reseller)
 Master Service Agreement (with DARTNet)
 BAA
 Statement of Work
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]

Facilitate decision making
 Approve technology solution
 Execution of contracts / agreements

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Champion this project with your providers
and IT staff
Identify opportunities for collaboration and
data use for research/QI
Scalable Architecture for Federated Translational Inquiries Network (SAFTINet)
Supported by the Agency for Healthcare Research and Quality (AHRQ) R01-HS019908
Principal Investigator: Lisa Schilling, MD, MSPH | [email protected]