Proposed S&I Public Health Reporting Initiative

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Challenge

-There is a lack of harmonized activities to enable electronic data exchange between clinical and population care and across PH-There is no consistent practice on reporting patient safety and PH events-Further HIT standardization efforts may become redundant or deficient without an unified approach for harmonization of PH business processes and functional requirements for PH information systems; and inclusion of public health in the full array of activities under the S&I Framework (standards harmonization and testing; standards-based product certification and deployment )

Scope Statement

-The goal of the S&I Public Health Reporting Initiative is to harmonize HIT standards and implementation guides for bi-directional communication between clinical care and public health entities for selected use cases.  -The Initiative will operate starting October 2011 through December 2013 and will strive to deliver deliverables for timely consideration of the HIT standards Committee during FY 2013.-At first, the Initiative will focus on individual-patient reporting from EHR systems to public health agencies (local, state and federal) for the Initial Case Notification reports .-Specifically, the Initiative will examine several reporting use cases that share similar business processes, information exchange requirements and data requirements. The Initiative will then select and harmonize standards, develop harmonized implementation guide(s), reference implementation(s) (testing) and certification criteria and processes for these use cases to be considered for Stage 3 of Meaningful Use. - In addition, the Initiative will identify a few sites to pilot test artifacts from this Initiative including the deployment of certified HIT products to enable interoperability of EHRs and public health information systems.-Lastly, we will develop a Roadmap for HIT standardization for public health reporting

Target Outcomes

Population Health, Business Process/(workflow/dataflow/architecture), Standards, HIT systems-Harmonized requirements and standards for PH and patient safety reporting for selected PH use cases within MU Stages-Harmonized implementation guides for public health reporting for selected PH use cases public health domains/programs-Unified approach for PH and patient safety reporting between clinicians and PH; and across PH at all levels of government-List of PH priorities (business cases) and a roadmap for HIT standardization for PH reporting between clinical care and PH; and

across PH agencies-List of PH programs for inclusion into S&I Framework Initiatives for Stage 3

Meaningful Use Alignment

Public Health Reporting Initiative is in alignment with ONC HIT Strategic Plan’s Goals (2011-2015)Goal 2: Improve Care, Improve Population Health, and Reduce Health Care Costs through the Use of Health ITGoal 5: Achieve Rapid Learning and Technological Advancement (

Potential Use Cases &

Scenarios

Use Cases 2011-2013Individual patient level reporting from EHR to

local/state/federal agencies focusing on Initial Case Notification Report

In the Future: Population (aggregate) level reporting from EHRs and reporting from local/state to federal agencies

User Stories (Business Cases)Maternal &child health, Communicable diseases, Chronic diseases,Immunization, Injury, Occupational safety and health, Adverse event reporting (drugs, biologics, devices, tobacco, foods), Medical countermeasures and emergencies, Surveillance

Standards and Stakeholders

Standards (examples)Data Standards (Vocabularies & Terminologies, eg, LOINC,

X12, SNOMED, UCUM, ICD10)Information Content Standards (HL7 RIM)Information Exchange Standards (eg, HL7 V2.x; HL7 CDA)Privacy & Security StandardsIdentifier Standards (eg, NPI)Functional Standards (eg, IHE)Business Process Standards (eg, BPMN, BPEL, UML)Interoperability Standards (eg, ONC S&I guides, HITSP

Interoperability specifications, IHE Profiles, HL7/SAIF)

StakeholdersCDC, FDA, ARHQ, HRSA, PHDSC, PHII, JPHIT, AIRA, ISDS, NACCHO, ASTHO, AHIMA, NAHDO, APHL,CSTE, NAACCR, HIMSS, SDOs, EHR Vendors Association , ACLA, Laboratory Information Systems Vendor Association, ONC Initiatives including Federal Health Interoperability Modeling and Standards Initiative /FHA/FHIMS, S&I Framework Initiatives (TOC, LRI and others), Others