cda state pilot project: timeframe nov-dec 2011 – recruitment and pilot design – de (dhin, dhie,...

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

oTBoHepBoFluoAntraxoTularemia

•Electronic Case Reporting (provider to local/state PH; and local/state PH to CDC)oTBoHepB oFluoAntraxoTularemiaoPlus 10 other conditions

o See CDA for Public Health Wiki Page:URL: https://wiki.phdsc.org/index.php/PH-Lab#PH-CDA_Templates_Work_List

•Public Health Case Reporting (from EMR - HIV or TB or Morbidity Report)

https://wiki.phdsc.org/index.php/PH-Lab#PH-CDA_Templates_Work_List

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 Leader1. Pilot Overview Document explaining the pilot to be replicable in other states

and domains – May 20121. Outline= IHE Volume 1 Write-Up or IHE PCC Workflow Profile 2011-2012

(ereferal and telemonitoring) – Draft 1/161. State Specific Description - Draft 2/28

2. Design the Pilot Architecture diagram1. State Specific Diagrams - Draft 2/28

2. Recruit/Form state pilot workgroups1. 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

ProviderEHR

laboratoryLIMS

Local or State PH Program

IS

HIE

Or

PH Communication

Server

For HL7 2.x messages:

Rhapsody to translate 2.x

messages and CDA

For CDA:RFD

NHIN ConnectXDS

DSUBNAV

Pseudonymize

Test Result

Test Result

Test Result

Case Report Case

Report

CDC PH Program

IS

Test Result

Case Report

Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH):

Proposed State-based Pilot Project Schema : Scope: 1,2,3

Test Order

Test Order

1

23

ProviderEHR

laboratoryLIMS


IS

HIEOr PH

Communication Server



messages and CDA

For CDA:RFD

NHIN ConnectXDS

DSUBNAV

PseudonymizeTest

Result

Test Result

Test Result

Case Report Case

Report

CDC PH Program

IS

Test Result

Case Report

Test Order

Test Order

1

23

4

Clinical Document Architecture Standard for Public Health (CDA for PH):Proposed Pilot Schema: DELAWARE

ProviderEHR

(Core CX360)

CCDContent to

Pre-populate TB Case Report

Delaware PH Communication Server/Router

(Orion Rhapsody)

LaboratoryLIMS

(Labware)CDA

TB Lab Report

Form Manager

(OZ)

CDA TB Case Report

CDA TB Lab Report

CDA for Public Health Pilot ProjectPublic Health Reporting Schema: DELAWARE - FINAL

ProviderEHR

(Core CX360)

CDA TB Case Report

Delaware PH Communication Server/Router

(Orion Rhapsody)

CDA TB Case Report

Delaware Electronic Reporting

Surveillance System(DERSS)

Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Schema: SAN DIEGO

ProviderEHR

(GMT?, McKesson?Allscript?,Cerner?)

San Diego PH System

(Atlas)

PH Infrastructure

/ Form Manager

(Atlas)

CDAPertussis

Case Report

CCDContent to

Pre-populate Pertussis

Case Report

Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Project Schema: SAN DIEGO - FINAL

Public Health Infrastructure

or HIE

Form Manager

(Oz Systems)

CDAPertussis

Case Report

ProviderEHR

(Allscripts, Test Harness)

CCDContent to


Case Report

SDCPH-IS

(Atlas Public Health)

Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Project Schema: NEW YORK STATE

Form Manager

(?)

PertussisCDA Case

ReportProvider

EHR•Connexin •Medent

CCDContent to


Case Report

NYS PH System•UPHN,•Rochester RHIO (Axolotl)•THINC (GSI)

Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Project Schema: NEW YORK STATE - FINAL

Public Health Infrastructure

or HIE

Form Manager

(Oz Systems)

CDAPertussis

Case Report

ProviderEHR

(Connexin)

CCDContent to


Case Report

NYS PH-IS

(UPHN)

User Story: State-Specific Story, Condition-Specific, User Story: State-Specific Story, Condition-Specific, Setting SpecificSetting Specific

Communicable Diseases, Outpatient FlowPatient, Provider/Physician, Laboratory, PH agency

1. Patient comes to Physician with symptoms of a disease.2. 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.

3. Physician orders lab and any diagnostic tests. Office staff takes samples and sends them to Laboratory. Any diagnostic tests are performed.

4. Laboratory performs ordered tests on received specimens. 5. Laboratory send results to Physician and PH agency (if needed)6. Physician re-examines clinical findings/diagnostic results and lab results;

sends report to a PH agency.7. Electronic message validated by PH agency/information system8. Electronic confirmation was sent from PH agency to Provider9. PH agency links lab report and case report to single individual.

User Story Names:Actors:

Flow of Events:

Pre-conditionPost-condition

Preferred Timing for Each Event Type

EHR SystemPublic Health Agency’s Information System

3-3 Setting: Provider (PCP) LWF Order Placer 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

3-6 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

3-2 Setting: Lab LW F Order Filler

OR XD*Lab Content Creator

(XDS.b) 3-4 HIE

Infectious Disease Surveillnce XD*Lab Content Creator

C32/CCD (XDS, Direct) Content Creator

(XDR)

3-1 Setting: Provider (PCP) LWF (or talking point) Order Placer

HIMSS Interoperability Showcase: Public Health Reporting Use Case

1

2

3

Scope: 1,2,3

ProviderEHR

laboratoryLIMS


IS

HIE

Or

PH Communication

Server



messages and CDA

For CDA:RFD

NHIN ConnectXDS

DSUBNAV

Pseudonymize

Test Result

Test Result

Test Result

Case Report Case

Report

CDC PH Program

IS

Test Result

Case Report

Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH): Proposed State-based Pilot Project Schema

Test Order

Test Order

cda state pilot project: timeframe nov-dec 2011 – recruitment and pilot design – de (dhin, dhie,...

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