Transcript CDAforPHPilotsSchema&ActionItems03-16-12

CDA State Pilot Project: Timeframe
• Nov-Dec 2011 – Recruitment and Pilot Design
– DE (DHIN, DHIE, DPH)
• HAI reporting via NHSN (national health & safety network)?
– CA? (Atlas Public Health)
– Greenway Technology
– Oz Systems
• Jan 2012- IHE Connectathon Testing
• Feb 2012 – HIMSS Showcase (Lab/case reports
for TB, HAI)
• January-April 2012 – Development
• May 2012- Pilot
Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH):
Proposed Public Health Programs for CDA for PH Pilot Project:
•Biosurveillance (with focus on laboratory data for influenza; and reporting decisions)
•Cancer
•Early Hearing Detection and Intervention (EHDI)
•Electronic Laboratory Reporting
oTB
oHepB
oFlu
oAntrax
oTularemia
•Electronic Case Reporting (provider to local/state PH; and local/state PH to CDC)
oTB
oHepB
oFlu
oAntrax
oTularemia
oPlus 10 other conditions, e.g. ,HAI, etc.
•HAI (the template for position statement in CSTE by 01/12) – check with DE
•Immunizations
•Public Health Case Reporting (from EMR - HIV or TB or Morbidity Report)
Action Items
• Statement of Work for Participating State(s) – 12/15
– (Mark, Anna, Marshall, Terese, Nitin, Lisa)
– DE Interoperability Model
• Pilot Scenario(s) (Lisa, Jib)
– Criteria for selecting conditions (standards are ready to go, morbidity/mortality
prevalence, other)
– Conditions – to be decided by CSTE and States - 12/15
• HIMSS Demo Scenarios – 11/28
• CDA Templates – Initial 02/2012
– (Sondra, Mark, Marshall, Anna, Nitin)
– TB, HAI (Atlas!)
• Technical Advisory Group (TAG) for State Implementations
– Define challenges to address
– APHL TAG for PHLIP as examples
– Advisors: Nitin (Oz Systems), Atlas, DE, Sondra’s team,
• Calls schedule: Dec 2 1-2pm ET. Every Other Friday 2-4 starting 12/9
• Outreach/Communication Plan for the Project – Ongoing – Maiko/CSTE/APHL
For TAG Leader
1. Pilot Overview Document explaining the pilot to be replicable
in other states and domains – May 2012
1. Outline= IHE Volume 1 Write-Up or IHE PCC Workflow
Profile 2011-2012 (ereferal and telemonitoring) – Draft 1/16
1.
State Specific Description - Draft 2/28
2. Design the Pilot Architecture diagram
1.
State Specific Diagrams - Draft 2/28
2. Recruit/Form state pilot workgroups
1. Identify/recruit senders-receivers vendors, PH programs, IT
support for actual site (DE, CA, TX, WI, CT; HISPC 10state
project model)
2. Define roles of the TAG members in the pilot and
unintended consequences
3. Work with state pilot workgroups to execute the pilot test –
invite APHL PHLIP TAGs and others – Flu Labs
4. Align with other pilots in PH and with S&I PH Reporting Pilots
PH Reporting Technical Framework
Public Health Report
Clinical Information
Source
Public Health
Report Consumer
ARPH
 XDS-MS, XPHR, LDS
Lab-1 Result
Message 
 Cardiology (TBD)
 XD*Lab
PCD-01 Device
 APSR
Result Message 
Public Health Reporting
Decision Processing
Entity
Initiate Public Health
Reporting Process
QRPH-xx
Public
Health
Report
Public Health
Report Source
Initiate Public Health Reporting Process QRPH-xx
 Send Distrib
Msg [QRPH-30]
 Recv Process
 Retrv Medical Definitions
(QRPH-Y1)
Knowledge
[QRPH-29]
Public Health Reporting
Requirements, Quality
Measure Requirements
Source
Public Health
Report Form
Manager
Deliver pre-pop
Public Health
report form
QRPH-yy
Retrieve Public
Health Report
Form along with
CCD pre-pop data
[ITI-34]
Public Health
Information
Source Form Filler
Submit Completed
Public Health Report
Form [ITI-35]
Public Health
Report Form
Receiver
Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH):
Proposed State-based Pilot Project Schema :
Case
Report
Provider
EHR
Test
Order
Test
Result
Test
Order
laboratory
LIMS
Test
Result
HIE
Or
PH
Communication
Server
For HL7 2.x
messages:
Rhapsody to
translate 2.x
messages and
CDA
For CDA:
RFD
NHIN Connect
XDS
DSUB
NAV
Pseudonymize
2
3
Case
Report
Scope: 1,2,3
1
Local or State
PH Program
IS
Test
Result
Case
Report
CDC PH
Program
IS
Test
Result
4
Case
Report
Provider
EHR
Test
Order
Test
Result
Test
Order
laboratory
LIMS
Test
Result
HIE
Or
PH
Communication
Server
For HL7 2.x
messages:
Rhapsody to
translate 2.x
messages and
CDA
For CDA:
RFD
NHIN Connect
XDS
DSUB
NAV
Pseudonymize
2
3
Case
Report
1
Local or State
PH Program
IS
Test
Result
Case
Report
CDC PH
Program
IS
Test
Result
User Story: State-Specific Story, Condition-Specific,
Setting Specific
User Story Names:
Actors:
Flow of Events:
Communicable Diseases, Outpatient Flow
Patient, Provider/Physician, Laboratory, PH agency
1.
2.
3.
4.
5.
6.
7.
8.
9.
Patient comes to Physician with symptoms of a disease.
Physician provides clinical examination and assesses medical history. If
patient’s symptoms require PH reporting w/o waiting for lab results,
sends a report to PH agency.
Physician orders lab and any diagnostic tests. Office staff takes samples
and sends them to Laboratory. Any diagnostic tests are performed.
Laboratory performs ordered tests on received specimens.
Laboratory send results to Physician and PH agency (if needed)
Physician re-examines clinical findings/diagnostic results and lab results;
sends report to a PH agency.
Electronic message validated by PH agency/information system
Electronic confirmation was sent from PH agency to Provider
PH agency links lab report and case report to single individual.
Pre-condition
EHR System
Post-condition
Public Health Agency’s Information System
Preferred Timing
for Each Event Type
HIMSS Interoperability Showcase: Public Health Reporting Use Case
3-1 Setting: Provider
LWF (or talking point)
Order Placer
3-3 Setting: Provider
LWF
Order Placer
3-2 Setting: Lab
LW F
Order Filler
OR
XD*Lab
Content Creator
(PCP)
3
(PCP)
XD*Lab (option)
Content Creator
AND
XPHR or EDR or XDS-MS (Referral Option)
Content Creator
AND
RFD
Form Filler
AND
SVS (option)
Value Set Consumer
1
(XDS.b)
3-4 HIE
(XDR)
Infectious Disease Surveillnce
XD*Lab
Content Creator
3-6
C32/CCD (XDS, Direct)
Content Creator
Setting: Public Health State
Disease Surveillnce
XD*Lab
Content Consumer
C32/CCD (XDS, Direct)
Content Consumer
RFD
Form Receiver
3-5 Setting: Public
Health Infrastructure
SVS
Value Set Repository
----RFD
Form Manager
Scope: 1,2,3
2
Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH):
Proposed State-based Pilot Project Schema
Case
Report
Provider
EHR
Test
Order
Test
Result
Test
Order
laboratory
LIMS
Test
Result
HIE
Or
PH
Communication
Server
For HL7 2.x
messages:
Rhapsody to
translate 2.x
messages and
CDA
For CDA:
RFD
NHIN Connect
XDS
DSUB
NAV
Pseudonymize
Case
Report
Local or State
PH Program
IS
Test
Result
Case
Report
CDC PH
Program
IS
Test
Result