Standards and InteroperabilityPublic Health Tiger Team (PHTT)

Our call will begin 3 minutes after the hour

Jim Daniel, MPH John Saindon, DrHSc, MTPublic Health Lead Health Scientist ONC CDC

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This meeting is being recorded and will be available via the S&I PHTT Wikihttp://wiki.siframework.org/Public+Health+Tiger+Team+Meeting+Archives

or via the following link http://vimeo.com/90761024

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Agenda• Request for member support• Behind the Scenes– Further collaboration with PHRi– Working with NIH to map EHDI CDE to the SDC CDE IG– Engaging with the Public Health Community Platform– PHI Conference

• Further development of the project charter– Challenge Statement– Scope– Value Statement– Success Criteria

• Request for Scenarios – NCHS, EHDI, IIS, PHTT 3

Proposed Scenarios from PHTT April 1

• How does public health integrate with EHRs?• Ability to send a referral directly• Ability to close loop on a referral• Screening and assessments done in a clinical setting, where

they fail want that information to come back to be able to act• Protocols that in place to anticipate screenings to prompt a

referral to state• Care coordination (many providers engaged in care and

communicate and share between all): monitor that a patient is complying, reminders, cross-agency, cross-program, cross-provider. Public Health equivalent of co-morbidity.

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PHTTS&I PUBLIC HEALTH TIGER TEAM

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S&I: Public Health Tiger Team (PHTT)

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Standards and Interoperability:

Public Health Tiger Team

Data Access Framework

Structured Data

Capture

Health eDecisions

Why consolidate into PHTT?

• Best use of resources and time• Assurance that these initiatives will have

Public Health Representation• Strengthened partnership between

community and vendor based partners• SDC/DAF/HeD work in parallel with each other

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Standards & Interoperability (S&I) Framework Overview

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S&I Framework Overview

• Specific health interoperability initiatives guide the design and development of a fully integrated and connected health information system.

• An S&I Initiative focuses on a single challenge with a set of value-creating goals and outcomes, and the development of content, technical specifications and reusable tools and services.

• Call for Participation: The overall success of the S&I Framework is dependent upon volunteer experts from the healthcare industry and we welcome any interested party to get involved in S&I Framework Initiatives, participate in discussions and provide comments and feedback by joining the Wiki: http://wiki.siframework.org

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Community Partners- (crowd sourcing)

• ONC• CMS• FDA• NLM• NIH• Vendors

• Local Public Health Organizations

• State Public Health Organization

• CDC• Public Health

Organizations

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SDCSTRUCTURED DATA CAPTURE

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Structured Data Capture Data Architecture

Infrastructure will consist of four new standards that will enable EHRs to capture and store structured data:1. Standard for the CDEs that will be used to fill the specified forms or

templates2. Standard for the structure or design of the form or template

(container)3. Standard for how EHRs interact with the form or template4. Standard to auto-populate form or template

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• Standards will facilitate the collection of data so that any researcher, clinical trial sponsor, reporting and/or oversight entity can access and interpret the data in electronic format

• Will leverage existing standards such as XML and CDISC Retrieve Form for Data Capture (RFD)

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EHR PHForm

Sample Types of

Reporting

Quality

Research

Public Health

Case Reporting (Pilot CDA)

EHR and SDC Model

ELR 2.5.1Immunization 2.5.1

Cancer CDA

Forms Repository

Request Form

(CDISC RFDC)Deliver Form

Deliver data from form{Format Type, TBD}

Example Types of Reporting

CDEsMeta DataBusiness

Logic

Define Forms

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Pilots

• Potential Pilots– Case Reports (STD, TB, Pertussis?)– EHDI– EP Cancer Reporting

• Next Steps– Common Data Element Formatting– Mapping to SDC IG– Identify Partners/Funding

DAFDATA ACCESS FRAMEWORK

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• Transport Layer —establishing a protocol for getting patient data from one place to another.

• Security Layer —ensuring that patient data will only be accessible to authorized parties.

• Query Structure —making sure the “question” being asked is phrased appropriately for the data to answer it. “Questions” could include “what were the pathology results of this patient’s last test” and “how many immunizations has this clinic provided each month in the past year.”

• Query Results —appropriately formatting the “answer” to the question posed. Pathology results may need to conform to clinical document architecture, while an answer about immunization counts could be presented as a simple bar graph.

•Data Model to Support Queries —information models that define concepts used in clinical care.

Query Health PilotsPilot Focus RI

QueriesRI Policy Layer

Data Sources Kickoff

NYC & NYS Depts. of Public Health

Diabetes (NYC)Hypertension (NYS)

i2b2 PMN RHIOsEHR Vendor

May 2012

FDA Mini-Sentinel

Use of clinical data sources for FDA questions

PMN PMN i2b2/Beth Israel

June 2012

CDC National / regional:- Disease syndromes- Situation awareness

i2b2 PMN Bio-Sense 2 July 2012

Mass. Dept. of Public Health

Diabetes PMN PMN MDPHNet July 2012

CQM Quality Measures hQuery PMN EHR Vendor August 2012

HeDHEALTH eDECISION

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HeD - Use Case 1

Pilots

• Planned– Pertussis reporting triggers

• Potential– Trigger SDC Report– Trigger Community Resource Referral (in

conjunction with SDC)

Where can you support?

• PHTT: Participate in weekly collaborative meetings

• SDC-PH: – mapping of CDEs into SDC format– Pilot site for proposed use case

• DAF-PH:

• HeD-PH

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PH TT Contact Information

ONC Public Health Lead: Jim (James) Daniel (james.daniel@hhs.gov) CDC Public Health Lead: John M. Saindon (uzn0@cdc.gov)

PHTT Wiki Page: http://wiki.siframework.org/Public+Health+Tiger+Team SDC Wiki Page: http://wiki.siframework.org/Structured+Data+Capture+InitiativeDAF Wiki Page: http://wiki.siframework.org/Data+Access+Framework+HomepageHeD Wiki Page: http://wiki.siframework.org/Health+eDecisions+Homepage

Weekly PHTT Meeting Info (Tuesdays):• Time: 2:00pm - 3:00pm Eastern• URL: https://siframework1.webex.com/• Dial-In Number: 1-650-479-3208• Access Code: 665 131 907

Thank you for your support. Q/A

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Standards and Interoperability:

Public Health Tiger Team

Data Access Framework

Structured Data

Capture

Health eDecisions