public health data standards consortium

Public Health Data Standards Consortium http://www.phdsc.org

http://www.phdsc.org/

Towards a Functional Standard on Electronic Data Exchange between

Clinical Care and Public Health

<Preliminary Findings>Contract # HHSH250200616198P from

Health Resources and Services Administration (HRSA)

Anna Orlova, PhDExecutive Director

2006 PHDSC-HRSA Project:

PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ 2007 BUSINESS MEETING OF MEMBERS ~

October 2-3, 2007, Hyattsville, MD

This presentation contains preliminary findings that have not been reviewed by

the PHDSC NHIN Committee

2006 PHDSC-HRSA Project

Towards Interoperability of

Clinical & Public Health Information Systems

2006 PHDSC-HRSA ProjectTo integrate the public health information systems into

the emerging electronic health information exchanges there is a need to:

Re-examine the ways the information systems in public health have been built to date

Introduce a ‘disciplined’ informatics approach into the public health information systems design and

Develop a common methodology of structured analysis of information needs at the user level that will guide the HIT projects

Built upon the PHDSC/HRSA Panel discussions we would like to propose a structured approach in developing interoperable electronic health information exchanges between clinical and public health information systems.


Interoperability is defined as the ability of two or more systems or components to exchange information and to use the information that has been exchanged.

Defining a Problem

Sources: 1. Institute of Electrical and Electronics Engineers. IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries. New York, NY: 1990.2. Health Level Seven (HL7). EHR Interoperability Work Group. Coming to Terms: Coming to Terms: Scoping Interoperability for Health Care. Draft. January 16, 2007. 35p.

Solving a Problem of Non-Interoperability

DHHS HIT standardization efforts are carried out by:American Health Information Community (AHIC)Office of National Coordinator for HIT (ONC)Health Information Technology Standards Panel (HITSP)Certification Commission for HIT (CCHIT)NHIN Developers

Problem SolutionNon-Interoperable

Health Information

Systems

Interoperable Health

Information Systems

DHHS Framework for Achieving Health Information Systems Interoperability

Step 1 - Identify National Use Cases Step 2 - Develop Use Case Document in a

standardized template Step 3 - Develop and Test Use Case

Interoperability Specification in a standardized specification template

Step 4 - Develop Certification Criteria for Use Case Interoperability Specification for EHRS products

Step 5 - Implement Use Cases

Problem Identified Problem Characterized Problem Managed Problem Evaluated

AHIC

Identify Use Cases

ONC

Develop Use Cases

HITSPDevelop

Interoperability Specification

CCHITDevelop Certification

Criteria

Problem Solution

NHIN DevelopersImplement Use Cases

Non-Interoperable Health

Information Systems

Interoperable Health

Information Systems


DHHS National Use Cases2006 Biosurveillance Consumer Empowerment (CE) Electronic Health Record (EHR)2007 Quality EHR-Emergency Response CE-Access to Information20086 more Use Cases


Questions for Consideration: How are National Use Cases selected? Are we creating again stand-alone, Use

Case-specific systems? Will the national Use Case

interoperability specifications meet local/state/regional health information needs?

Is there a process that may prevent us from designing stand-alone system while using the Use Case approach?


To address these Questions we propose to incorporate Business Process Analysis and Information Systems Functional Requirement Analysis methodologies into the development of the interoperability specifications for HIT applications.


Business Process Analysis will be used to identify national Use Cases based on the strategic goals for HIT adoption.

Functional Requirement Analysis will be used to refine the national interoperability specifications to address local/state/regional needs for health information exchanges.


Business Process Analysis (BPA) Components Enterprise analysis - strategic direction and goals;

solutions that will allow to meet those strategic goals Requirements planning and management -

planning the requirements development process and managing change

Requirements elicitation - techniques for collecting requirements from stakeholders

Requirements analysis - techniques for specifying requirements

Requirements communication - techniques for ensuring shared understanding of the requirements

Solution assessment and validation – verification of correctness of a proposed solution

Business Process Analysis (BPA) Outcomes

An improvement of information management may be identified via BPA among other solutions to meet organization’s strategic goals.

For this solution, there may be a need to develop (or improve) an information system. The description of this solution can be done in a format of a Use Case.

Functional Requirement Analysis for Information System Design

In the information system design, Functional Requirement Elicitation and Analysis (FRA) are used to specify end user work processes and data exchange needs that the information system will support.

The Functional Requirement Analysis Document (FRAD) is a product of FRA, i.e., functional standard.

Functional Requirements Analysis Document (FRAD) Components

Problem/Domain (Use Case) Description for which Information System is needed

Information System (IS) Goals Actors – end users in information exchange that IS will support Functional Requirements – list of end user functions that IS

will support Storyboard – examples of life-situations in end user work that

IS will support Diagrams of end user interactions with the IS High Level System Architecture – graphic representation of

end user view of IS operation Non-functional Requirements - list of IS features, e.g.,

privacy & security IS Development Timeline and Deliverables

We propose to incorporate Business Process Analysis and Information Systems Functional Requirement Analysis methodologies into the development of the interoperability specifications for HIT applications.


AHIC

•Biosurveillance•Consumer Empowerm:

•Pt registration•Meds History

•EHR-Lab•EMS•Quality

ONC

Develop Use CasesDevelop & TestInteroperability

Specification

CCHITDevelop

Certification Criteria




HITSP




Identify Use Cases

NHIN Developers

Implement Use Cases

Step 1Step 3Step 2 Step 4

Step 5


BPA / AHICBusiness Process

Analysis ofDomains/Programs

•Biosurveillance•Consumer Empowerm.:



ONC

Develop Use Cases Develop & TestInteroperability

Specification

CCHITDevelop

Certification Criteria•Biosurveillance

•Consumer Empowerm. •Pt registration•Meds History


HITSP




Identify Use Cases

NHIN Developers

Implement Use Cases

FRADDevelop Functional Requirements Analysis Document (FRAD)•Biosurveillance•School Health

Inform Certification Criteria Development

Step 1Step 3Step 2 Step 4

Step 5Step 7 Step 8

Step 6Pilot Test

Enhancing DHHS Framework for Achieving Health Information Systems Interoperability

Recommendations1. Work with the Public Health Informatics Institute

to refine the proposed approach of integrating BPA and information systems FRA into the national interoperability specification development efforts; and

2. Present the proposed approach to the successor of the American Health Information Community as a methodology for

selecting national Use Cases, and refining the national Use Case interoperability

specifications to address local, state and regional needs of health information exchanges


public health data standards consortium

Documents

health care

health level

health resources

use casesdhhs framework

national use casesstep

use case document

public healthcontract

scoping interoperability