assessing state ehdi programs’ capability for standards-based health information exchange
DESCRIPTION
Assessing State EHDI Programs’ Capability for Standards-Based Health Information Exchange. Jim Jellison, MPH Deb Bara, MA. Topics. Overview of EHDI Barriers to EHR – Public Health interoperability EHDI interoperability capability maturity model. PHII’s Mission. - PowerPoint PPT PresentationTRANSCRIPT
Assessing State EHDI Programs’ Capability for Standards-Based Health Information ExchangeJim Jellison, MPHDeb Bara, MA
PHII.org
Topics
• Overview of EHDI• Barriers to EHR – Public Health interoperability• EHDI interoperability capability maturity model
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PHII’s Mission
To improve health outcomes worldwide by transforming health practitioners’ ability to apply information effectively.
We do:• Business process analysis, systems
requirements• Evaluations, recommendations• Training
PHII.org
Early Hearing Detection & Intervention (EHDI)
• Goal: promote children’s communication and development from birth by detecting hearing loss and intervening.
• Universal Newborn Hearing Screening:– 1989: ~3% ; 2011: >98%– Hearing loss prevalence: 1.5 per 1000 screened– Of those screened, 35% LTF/LTD
• Providers often lack EHDI knowledge, skills
Sources: CDC MMWR (1/30/2004)CDC Annual EHDI Data ReportsShulman, et al. Pediatrics (Suppl., Aug 2010)
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EHDI Clinical Workflow
Hearing ScreenBirth
Pass
1 Month
No Hearing Loss
FailAudiologic
Exam
PassNo Hearing
Loss
FailEarly
Intervention
3 Months 6 MonthsGoal:
Sources: Joint Committee on Infant Hearing (JCIH); Centers for Medicare & Medicaid Services (CMS)
2014 Clinical Quality Measure: % screened for hearing loss beforehospital discharge
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EHDI Information Exchange Context
ScreeningDevice
BirthingCenter
Birth Registry
EHDI
Pediatrician
Birth Event
Screening Results
Care Plan
Birth Event
Hospital Public Health
Primary Care
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EHDI Information Exchange Standards (IHE Profiles)
ScreeningDevice
BirthingCenter
Birth Registry
EHDI
Pediatrician
Newborn AdmissionNotification Information
Device Enterprise Communication*
Early Hearing Care
Plan*
(Birth Event)
Hospital Public Health
Primary CareAcknowledgments:IHE QRPH DomainLisa Nelson (consultant)Lura Daussat (OZ Systems)
* To be replaced withEHDI Profile
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IHE EHDI Profile (CCD)
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PHII.org
Performance Improvement Tool
Adapted from C4ISR AWG Architectures Working Group, Department of Defense. 1998. Levels of Information Systems Interoperability (LISI). Washington, D.C.: United States Department of Defense.
Interoperability
Workflow Policies
InfrastructureData &
Standards
Receiving notices
Sending care plans
De-duplicatingevents
Informatics strategy
Data sharing agreements
Privacy, confidentiality
Workforce
HIE
IT Architecture HL7
SNOMED,LOINC
IHE
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Capability Maturity Model
Adapted from the Capability Maturity Model developed by the Software Engineering Institute at Carnegie Mellon University.
Capability Maturity Model is registered service mark of Carnegie Mellon University.
Level 0None
Level 1Initial
Level 2Managed
Level 3Defined
Level 4Measured
Level 5Optimized
No awareness or efforts
Isolated, ad-hoc efforts;Individual heroics
Repeat early successes;Begin to establish processes
Routine processes, documented procedures;Established governance, policies
Evaluation of procedures, processes
Use evaluation results to improve
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Workflow
Can the EHDI program identify all live birth events in its jurisdiction?
Level 0None
Level 1Initial
Level 2Managed
Level 3Defined
Level 4Measured
Level 5Optimized
Unable to conduct these activities.
Manual;Inconsistent results;Many unresolved duplicate birth events.
Combine manual, automated approaches; Inconsistent results;Some unresolved duplicates.
Evaluation of automated live birth event identification process.
Use of evaluation findings to improve live birth event identification process.
Automated approaches;Consistently good results;Few unresolved duplicate birth events.
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Policies
Does your agency have a governance process that guides IT projects?
Level 0None
Level 1Initial
Level 2Managed
Level 3Defined
Level 4Measured
Level 5Optimized
No such governance structure.
Agency has made isolated, ad-hoc efforts to govern information systems projects.
Agency has made sustained attempts at governing information system projects.
Agency has established such a governance process and evaluates how well it guides IT projects towards agency objectives.
Agency uses evaluation findings to improve governance of information systems development.
Agency has established such a governance process and exercises it regularly.
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Benefits to EHDI Program
• Better understanding of current interoperability readiness
• Evidence for additional resources• More collaboration between EHDI, IT, agency
leadership• More informed national strategy for capacity
building
