Newborn Hearing Screening Results and Diagnostic Reports Exchange Project Utah Digital Health Commission Meeting March 3, 2016

Project Purpose To expand the use of the existing state designated clinical Health Information Exchange (cHIE) to improve the care coordination for newborn hearing screening and follow-up results in the state of Utah 2

Project Partners Utah Health Information Network (UHIN) – (cHIE) Intermountain Healthcare Child Health Advanced Records Management (CHARM) Program Utah Early Hearing Detection and Intervention (EHDI) Program – (HiTrack) Multidimensional Software Creations (MDSC) Center for Health Data and Informatics Center for Disease Control – EHDI Program 3

Background National Early Hearing Detection and Intervention (EHDI) Goals Screen for hearing loss before 1 month of age Diagnose hearing loss before 3 months of age Enroll a child with hearing loss in Early Intervention before 6 months 4

Background (continued) 51,873 births in Utah in % screened for hearing loss, 98% prior to 1 month Of those screened, 492 did not pass –13.2 % did not complete further testing and were lost to follow-up 77.9% diagnosed before 3 months 77.3% children confirmed as Deaf/Hard of Hearing (D/HH) were enrolled in Early Intervention before 6 months 5

Objectives/Use Cases Use Case 1 Send clinical reports from Intermountain’s EHR through the cHIE's Direct Service to deliver diagnostic Auditory Brainstem Response (ABR) results and Cytomegalovirus (CMV) results to the EHDI program Use Case 2 Send hearing screening results from EHDI's HiTrack system through the UDOH CHARM system and interoperability Gateway to the cHIE to Intermountain providers Both use cases apply to the statewide pediatric population up to 6 years old ( ̴ 300,000 children) 6

Project Metrics Use Case 1 and 2: Connections made between public health (EHDI) and other entities (Intermountain and UHIN/cHIE) = 2 Use Case 1: Intermountain will track and determine the number of diagnostic reports sent to EHDI via Direct EHDI will track and determine the number of diagnostic reports received from Intermountain 7

Project Metrics (Continued) Use Case 2: UDOH, UHIN, Intermountain will track and determine the number of hearing screening results/messages sent and received between each entity 8

Use Cases Implemented EHDI program will be using Direct Service to get diagnostic ABR and CMV test results from Intermountain and share outcomes/lessons learned Intermountain will be utilizing the newborn hearing results from cHIE in their EHR and share outcomes/lessons learned Outcomes will show improvement in hearing screening follow-up and the EHDI Program’s goals 9

Complex nature of finding common codes to enable the transfer of ABR and CMV lab results between Intermountain and the EHDI Program - The UDOH and Intermountain worked together to gather national resources, andIntermountain matched EHDI lab result codes with their lab and LOINC* codes to resolve this challenge. *LOINC = Logical Observation Identifiers Names and Codes is a database and universal standard for identifying medical laboratory observations. Challenges 10

Successes Significant progress made with Use Case 1 – ahead of schedule Partners committed; Buy-in from beginning Good communication/rapport Meet regularly to move tasks forward 11

Christine Perfili, MBA, B.S. Program Manager, Child Health Advanced Records Management (CHARM) ONC HIE Grant Project Director Children with Special Healthcare Needs Bureau Utah Department of Health Stephanie McVicar, Au.D., CCC-A Director, Utah Early Hearing Detection and Intervention (EHDI) Cytomegalovirus Public Health Initiative Children with Special Healthcare Needs Bureau Utah Department of Health (801) Please Contact 12