Primary Goal: To support case detection and investigation for the reportable infectious diseases (conditions) using electronic information exchanges between clinicians, laboratories, and public health registries. This scenario demonstrates interoperability between a physician's electronic health record (EHR) system, a laboratory information management system (LIMS), and the local/state/national Public Health Infectious Disease Registry (surveillance system). The scenario is focused on pertussis.Key Points:• Provide laboratory information from LIMS and clinical information from physician EHR to a local/state Public Health State

Infectious Disease Registry on all patients diagnosed with a reportable condition • Public Health Reporting decision support triggered from the Health Information Exchange (HIE) • Public Health Disease Monitoring • The use of Clinical Data Architecture (CDA) to define content for Public Health Reporting data exchange is demonstrated

Meaningful Use Relevance: MU of Health IT Objective 4: Improving Quality and Population Health.

Care Theme: Leveraging Healthcare Registries in Care DeliveryUse Case: Improving Population Health via Biosurveillance Monitoring and Detection

Use Case 3

Domain Profile Vendors ActorsLaboratory (LAB) XD*Lab Axway,

GE, CDC-AtlasContent Creator,

Consumer

Patient Care Coordination (PCC)

XDS-MS GE Content Creator, Consumer

IT Infrastructure (ITI) XDS GDIT Consumer, Source, Registry, Repository

PIX, PIXv3, PDQ GDIT PIX Manager, PDS Server

XDR Axway, CDC-OZ, CDC-Atlas

Document Source, Recipient

RFD CDC-OZ, CDC-Atlas Form Manager, Filler, Receiver

SVS 3M, CDC-OZ Value Set Repository, Value Set Consumer

IHE

Prof

iles

& A

ctor

s

Care Theme: Leveraging Healthcare Registries in Care DeliveryUse Case 3 : Improving Population Health via Biosurveillance Monitoring and Detection

Clinical Workflow:

1. Patient presents to PCP with symptoms of Pertussis Suspect sample taken in office and sent to the laboratory

2. Specimen is analyzed and laboratory results indicate the reportable condition. The results are sent to the ordering provider, and to the Public Health Infectious Disease Registry via the HIE Interface. Alternatively, locally available analytic tools support determination of reportable results

3. Results from the LIMS are available to provider EHR. Provider confirms that the patient has a pertussis which is a reportable condition. EHR sends the Initial Case Notification Report to the Public Health Infectious Disease Registry 4. The HIE offers value-added services such as: Transforms message to a Laboratory Report that is human readable & machine readable; Translates the local codes to LOINC codes (if necessary); Registers the laboratory result in the HIE for provider for continuity of care; Analyzes the result content to determine whether the result is a reportable event; Sends the laboratory result to Public Health Infectious Disease Registry as a reportable condition

5. Public Health Infrastructure Services are Provided for Form Management and Vocabulary Value Sets supporting the case reporting analytics

6. Public Health Infectious Disease Registry receives reports from Provider EHR and LIMS via the HIE: Public health defines and publishes infectious disease reporting requirements using standard human-readable and machine-readable formats (HQMF); State Epidemiologist monitors the number of cases through visualization tools

6- Public Health Infectious Disease Registry

4- HIE Provide Value-added services

1- PCPPlace order

2- LabSend results

3- PCP Send case report 5- Public Health

InfrastructureProvide services

Send laboratory report

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