Public Health Reporting Initiative

June 13, 2012

Agenda

Topic Time Allotted

Welcome / Agenda Overview - John Stinn 4:00 - 4:05

Functional Requirements Update - John Stinn 4:05 – 4:15

Data Mapping Update – Nikolay Lipskiy 4:15 – 4:25

Stage 3 Readiness Update – Seth Foldy 4:25 – 4:45

NwHIN Governance RFI

Discussion 4:45 – 5:00

Adjourn 5:00

Functional Requirements

• Draft of the functional requirements document, including graphics depicting the public health reporting workflow, has been posted to the wiki (http://

wiki.siframework.org/PHRI+Functional+Requirements) for public comment– Immunization comments

• Comments due by Friday, June 15,2012 using the discussion board or by emailing lrbrown@cdc.gov

• Next Steps– Update current document– Post updated document for public comment (note: to be

released in a package including the data elements)

Data Mapping Update

• Working with user story submitters to refine and finalize– User Story / Domain specific data elements– Core / consolidated initiative-level data elements

• Next steps– Public Comment for domain-level data elements (note: to

be released in a package with the functional requirements)– Continue work on data modeling– Complete data harmonization document with both

domain-level and initiative-level data elements

Public Health Reporting Initiative

Stage 3 Readiness andStage 3 Implementation Specification Sprint

These slides represent an interpretation of Readiness Self-Assessments and do not necessarily represent

the position of any agency or organization.Proposals are for discussion purposes only.

Observations

• ELR and Syndromic user stories did not reply• IIS felt questions were unresponsive to HL7

2.5.1 IIS systems primarily interested in bidirectional exchange

• Many unclear on 2015 implementation funds

Interpretation Guide

• Focus on unidirectional reporting from EHR to PH?• Consensus about data element standards (elements,

terminology, value sets?)• Preferred exchange standard (2.x vs. CDA vs. other)• Primary (potential) federal agency identified• Primary stakeholder association identified• Capability for pilot in Summer/Fall 2012?• Likely receiving capability in Oct. 2015• Number of receiving systems• Source of report: ambulatory versus hospital• National scope of reporting

User Story Unidirectional ConsensusStandards

Data exch.standard

Reportable condition case reporting Yes Yes CDA or 2.x†

Healthcare acquired infection reporting Yes Yes CDA or 2.x†

Cancer registry reporting** Yes Yes CDA or 2.x†

Early Hearing reporting* Yes Yes CDA or 2.x†

Birth and fetal death reporting Yes Yes CDA or 2.x

Drug adverse event reporting Yes Yes CDA or 3.x?

Medical device adverse event reporting Yes Yes CDA or 3.x?

Vaccine adverse event reporting Yes Old CDA/2.x/3.x?

Natl. Hospital Care Survey Yes No‡ CDA or 2.x

Immunization registry exchange No Yes 2.x only

Tobacco quit line exchange No No None

BRCA counselling registry reporting Yes No Neither

* Considering outbound components only †preference for CDA?** Considering ambulatory case report only ‡single Federal user

User Story USG program StakeholderAssn.

Pilot 2012

Reportable condition case reporting CDC/DNDHI CSTE Yes

Healthcare acquired infection reporting CDC/DHQP/NHSN

CSTE/SHEA/APIC

Yes

Cancer registry reporting CDC/DCPC NAACCR Yes

Early Hearing reporting* CDC/DHDD JCIH/DHSPSHWA Feb 13

Birth and fetal death reporting CDC/NCHS/DVS NAPHSIS Yes

Drug adverse event reporting FDA/CDER Int. Conf Harm Yes

Medical device adverse event reporting FDA/CDRH‡ none‽ Yes

Vaccine adverse event reporting CDC/DHQP/ISO† ICH? ?

Natl. Hospital Care Survey CDC/NCHS/DHCS none‽ Yes?

Immunization registry exchange CDC/IISSB AIRA ??

Tobacco quit line exchange CDC/OSH N.AmQLCons No ¶

BRCA counselling registry reporting CDC/DCPC none No

*Considering outbound components only ** Considering amb. Case report only¶ Proprietary approach pilot †also FDA ‡also reported via PSOs to AHRQ ‽One user only

User Story Implement 2015

NumberReceivers

Hosp/Amb

Reportable condition case reporting Yes? 55 (18 NBS) Both

Healthcare acquired infection reporting Yes 1 Hosp

Cancer registry reporting** Yes 63 Amb

Early Hearing reporting* Yes? 59 Both

Birth and fetal death reporting Yes? 57 Hosp‡

Drug adverse event reporting Yes 1 Both

Medical device adverse event reporting Yes 1/also PSOs Both

Vaccine adverse event reporting Unk 57 vs 1?† Both

Natl. Hospital Care Survey Yes? 1 Hosp

Immunization registry exchange ?? 57? Both

Tobacco quit line exchange Unsure 16 (53 jurisd) Both

BRCA counselling registry reporting Unsure 2 Amb

*Considering outbound components only **ambulatory case report only †may use IIS’s‡ Could also include outpatient records

User Story Breadth ProposedTier

Reportable condition case reporting Nationwide 1

Healthcare acquired infection reporting Nationwide 1

Cancer registry reporting** Nationwide 1

Early Hearing reporting* Nationwide 1

Birth and fetal death reporting Nationwide 1

Drug adverse event reporting Nationwide 1

Medical device adverse event reporting Nationwide 1

Vaccine adverse event reporting Nationwide 2

Natl. Hospital Care Survey 500 hosps (10%) 2

Immunization registry exchange Most states 2

Tobacco quit line exchange Most states? 2

BRCA counselling registry reporting 2 states 2

* Considering outbound components only **ambulatory case report only †may use IIS’s

Proposal

• Tier 1: 7 stories appear with relatively high level of readiness; focus on unidirectional; broad national scope

• Tier 2: 5 stories with either less readiness and/or focus on bidirectional and/or lesser scope

• Venders: want to recruit industry reps• Goal: a process that permits all to benefit while

maximizing chance for pilot-tested Stage 3 Impl. Spec. by November

ProposalTier 1 Agencies and Associations

EHR & PH System and Intermediary Vendors

Tier 2 Agencies and Associations

All attempt to achieve consensus. If Tier 2 issues threaten timely consensus onan issue they agree to withdraw on that issue.

Possible Process

1. Ground rules2. Consensus on common “core” elements3. Consensus on HL7 2.x or CDA or both formats4. Address how “core” elements and different

“extension” elements are managed5. Address how “trigger” and “filter” knowledge

base should function.

NwHIN RFI

Public Comment Period Extended until Friday, June 29th

In response to requests from the public for additional time, ONC has extended the comment period for the Nationwide Health Information Network: Conditions for Trusted Exchange Request for Information (RFI) until to Friday, June 29th. Comments will be accepted through regulations.gov up until 11:59PM Eastern Daylight Time.

To comment on the RFI please go to http://www.regulations.gov/#!documentDetail;D=HHS-OS-2012-0006-0001. 

Can contact Bbrand@phii.org for JPHIT FAQ sheets