PH Reporting Health IT Standardization Framework Proposal for Review

PH Reporting Health IT Standardization Framework

Proposal for ReviewS&I PH Reporting Initiative-Call 10/12

Acknowledgements:

Public Health Data Standards Consortium (PHDSC)

National Association of City and County Health Officers (NACCHO), USA

Participants of the NACCHO Workshop on Business Process Analysis in Public Health, Salt Lake City, UT, December 2011

Centers for Disease Control and Prevention (CDC), USA

Quality, Research and Public Health Committee, Integrating the Healthcare Enterprise (IHE)

Public Health and Emergency Response Workgroup, Health Level Seven (HL7)

Structured Documents Workgroup, HL7

State Health DepartmentOrganizational Chart

From Connectivity to InteroperabilityHealthcarePublic HealthTODAYHealthcarePublic HealthTOMORROW

The operation of local, state and federal public health agencies under the core public health functions (assessment, policy and assurance) is focused on enabling resources and services for the publics health protection. The public health operates under the following business areas:

Population Know population that is servedResources Know healthcare capacities and other resources avaliable to the populationEnvironment Know the environment in the jurisdiction to prevent and control possible unhealthy exposuresProtection Protect the public in the jurisdiction from infectious diseases and exposure to disease risk factors, environmental and injury hazards and natural disasters Healthy Development & Wellness Promote healthy pregnancy, child development, and ongoing wellness for the served populationDirect Care Enable access to care for underserved population and people with special needs Agency Operation Enable program operation to provide services to the population in needResearch Conduct research to evaluate public health interventions and to develop new interventions

Harmonizing Public Health Operation across Various Domains/Programs

Business Processes: Patient & Population Level

Core Public Health FunctionsPublic Health Business ProcessesPatient-levelPopulation levelASSESSMENTEvent identificationOutbreak identificationEvent investigationOutbreak investigationEvent managementOutbreak managementASSURANCE Event management evaluationOutbreak management evaluationPOLICYMitigationMitigation

Examples of Interoperability Standards by Information Systems Function

Information System FunctionsExamples of Related IHE Profiles and StandardsCollect DataRFD, XDS, LAB TF (XD*Lab, Lab message), QRPH content (EHDI, PRPH-CA, MCH, DSC), PCC Content (LDS, XDS-MS, XPHR, IC), RPE, RDA, XD* with HL7 CDA for PH ReportingReporting Requirements (Pending HL7 work)Report Criteria Guideline ManagerPractice ManagerData Source Workflow (XDW)Manage Data (upload, maintain, delete)Control Access (XUA, ATNA), records matching, anonymization/ pseudonymizationAnalyze Data(Statistical methods, Aberration algorithms (DSUB, MPQ), Retrieve Medical Knowledge QRPH-29Integrate DataIT Infrastructure Profiles (PIX, PDQ, XDS, XDR, On-Demand Documents, XDW)Report DataPDF, Maps, Send Distribution QRPH-30

Public Health Business AreasNACCHO-PHDSC Business Process Analysis for Pubic Health: Project Findings

Public Health Business ProcessesIndividual/PopulationPublic Health Business AreasNACCHO-PHDSC Business Process Analysis for Pubic Health: Project Findings

Public Health Business ProcessesIndividual/PopulationInformation Systems FunctionsPublic Health Business AreasNACCHO-PHDSC Business Process Analysis for Pubic Health: Project Findings

Public Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Public Health Business AreasNACCHO-PHDSC Business Process Analysis for Pubic Health: Project Findings

Public Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content PopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchPublic Health Business Areas

Event/Outbreak IdentificationEvent/Outbreak InvestigationPublic Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Event/Outbreak ManagementEvent/Outbreak ManagementEvaluationMitigationPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchPublic Health Business Areas

Event/Outbreak IdentificationEvent/Outbreak InvestigationPublic Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Event/Outbreak ManagementEvent/Outbreak ManagementEvaluationMitigationCollect DataManage DataIntegrate DataAnalyze DataReport DataPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchPublic Health Business Areas

Event/Outbreak IdentificationEvent/Outbreak InvestigationPublic Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Event/Outbreak ManagementEvent/Outbreak ManagementEvaluationMitigationCollect DataManage DataIntegrate DataAnalyze DataReport DataGuidelinesEvent/Case/Outbreak ReportsAlert & NotificationQuality ReportsEducational MaterialsLab ReportsCare PlansPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchPublic Health Business Areas

Public Health Program Examples:

Early Hearing Detection & Intervention (EHDI) andPublic Health Laboratory (PH-Lab)

Public Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Public Health Business AreasWorkflow StandardsHealth IT StandardsContent StandardsUse CasesGuiding the HIT Standardization for Public Health

Business Areas: Early Hearing Detection & Intervention

Business Areas: Public Health Laboratory

Business Areas: Early Hearing Detection & InterventionInitial PH report: Hearing Screening report

Business Areas: Public Health LaboratoryInitial PH report: Lab Test Report

Event/Outbreak IdentificationEvent/Outbreak InvestigationPublic Health Business ProcessesIndividual/PopulationInformation Systems FunctionsData Content Event/Outbreak ManagementEvent/Outbreak ManagementEvaluationMitigationCollect DataManage DataIntegrate DataAnalyze DataReport DataGuidelinesCase/Outbreak ReportsAlert & NotificationQuality ReportsEducational MaterialsLab ReportsCare PlansPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchPublic Health Business Areas

Newborn Hearing ScreeningWorkflow Short-Term Care Follow-up WorkflowEvent IdentificationEvent InvestigationEvent ManagementLabor & Delivery SummaryHearing Screening Order/ResultsMS: Hearing Risk FactorsLabor & Delivery WorkflowEarly Hearing Care PlanUpdated Hearing Care PlanNewborn Care WorkflowHearing Screening Quality MeasuresEarly Hearing Detection and Intervention (EHDI) ProgramWorkflow StandardsHealth IT StandardsContent StandardsUse CasesPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchInitial PH Report

LaboratoryWorkflow Case Management WorkflowEvent IdentificationEvent InvestigationEvent ManagementChief ComplaintMedical SummaryLab order/ ResultsRisk FactorsVisit to ProviderCase ManagementPlanUpdatedPlanCase InvestigationWorkflowPH QuestionnaireCommunicable Diseases Programs (Lab Data)Workflow StandardsHealth IT StandardsContent StandardsUse CasesPopulationResourcesEnvironmentProtectionWellnessDirect CareOperationsResearchInitial PH Report

Business Processes, Data Content, Standards: Early Hearing Detection & Intervention & PH Labs

Business Processes /ActivitiesInformation Exchange Content by DomainExamples ofIHE Interoperability StandardsEHDIPH-LabPreparedness (Anthrax)Surveillance (Influenza)CASE IDENTIFICATIONTrigger: Due for screening / Present with symptoms Input:Notification of birthOutput: Standing orderInput: Medical SummaryOutput: Test OrderInput: Medical Summary Output: Test OrderXDS-MS/XPHR/C32 XDS/XDR/Lab-Technical Framework (TF)PIX/PDQ/QRPH29 Retrieve medical knowledge/PCC Care Management TFTrigger: Order test/Standing order for the testInput: Consent (or by statute)Output:Test orderInput: Consent (or by statute)Output:Test orderInput: Consent (or by statute)Output:Test orderBPPCLAB TFTrigger: Conduct test Input: Test orderOutput:Test resultsInput: Test orderOutput:Test resultsInput: Test orderOutput:Test resultsPCD-01/LAB TF/ RFD/XDR/DSUB/NAV

Actors and Information Systems: Early Hearing Detection & Intervention (EHDI) & PH LabsN/A Not applicable

Information Systems (Technical Actors)Business Actors by DomainEHDIPH-LabHospital EHR-SBirthing FacilityER, InpatientAmbulatory EHR-SPediatricianOutpatientMedical DeviceHearing Screening DeviceN/ALIMSN/APublic Health Laboratory,Clinical Laboratory,Reference LaboratoryPublic Health Information Systems (IS)EHDI ISDisease-Specific IS

Interoperability Standards Schema: Early Hearing Detection & Intervention & PH Labs

( Retrv Medical Knowledge [QRPH-29]

( Send Distrib Msg [QRPH-30]

Initiate Public Health Reporting Process QRPH-xx(

Initiate Public Health Reporting Process QRPH-xx(

Public Health Report Source

(Deliver pre-pop Public Health report form QRPH-yy

Submit Completed Public Health Report Form [ITI-35](

Public Health Information Source Form Filler

Public Health Reporting Requirements, Quality Measure Requirements Source

( Recv Process Definitions (QRPH-Y1)

Public Health Report Form Receiver

Public Health Report Consumer

(Public Health Report

Retrieve Public Health Report Form along with CCD pre-pop data [ITI-34](

( XDS-MS, XPHR, LDS

( Cardiology (TBD)

( XD*Lab

( APSR

ARPH(

Lab-1 Result Message (

PCD-01 Device Result Message (

Public Health Report Clinical Information Source

Public Health Reporting Decision Processing Entity

Public Health Report Form Manager

PH Reporting Health IT Standardization Framework

Request for Comments by October 21, 2011S&I PH Reporting Initiative

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