Daniel Pollock Centers for Disease Control and Prevention Atlanta, GA Project Proposal: Additions to the C-CDA Continuity of Care and Discharge Summary Documents for Purposes of Enabling More Complete Exchanges of Infectious Disease, Microbiology Results, and Antimicrobial Treatment Data Daniel Pollock Centers for Disease Control and Prevention Atlanta, GA HL7 Structured Documents Work Group Meeting September 13, 2017

Project Proposal: Initial Team (Additions Expected) CDC Sheila Abner Austin Kreisler Daniel Pollock Sheri Tejedor Illinois Department of Public Health Erica Runningdeer Lantana Consulting Group Emilie Cousineau Sarah Gaunt Kim Glenn

Project Proposal: Problem to be Addressed and CSTE’s Position Statement* Problem: Gaps in infectious disease-related data (diagnoses, laboratory results, and treatments) in clinical documents that are created and exchanged when patients are transferred between healthcare facilities or discharged from a facility for follow up Impetus: A Council of State and Territorial Epidemiologist (CSTE) position statement, approved by CSTE members in 2016, on Interfacility Communication to Prevent and Control Healthcare-Associated Infections and Antimicrobial Resistant Pathogens Across Healthcare Settings www.cste.org/resource/resmgr/2016ps/16_ID_09.pdf Actions Sought by CSTE: To enable improved patient-specific communications, CSTE’s position statement calls for an update to two document types included in the Health Level Seven (HL7) Consolidated-CDA (C-CDA) standard: Continuity of Care Document (CCD) and Discharge Summary *CSTE position statements are policy documents--authored, vetted, and approved by organizational members--that call for specified actions in response to public health issues. CSTE is a non-profit professional organization that draws most of its membership from the local, state, and federal public health agency workforce.

Project Proposal: Goals Goals: More complete data exchanges for purposes of improving - Patient care Examples of improvements sought: More timely infectious disease contact precautions at receiving facilities Avoiding duplicate laboratory testing when patients are transferred - Continuity of appropriate antimicrobial treatment across care settings Public health More complete and accurate healthcare-associated infection surveillance More complete and accurate information available for decision support systems to identify public health reportable events More rapid and targeted responses to antimicrobial resistance problems

Project Proposal: Participants and Proposed Sponsors Clinical practitioners (CDC consultants, other contributors) Public health professionals (CDC, Illinois Department of Public Health, other state and local health departments) CDA experts (Lantana Consulting Group) Vocabulary specialists (Lantana Consulting Group, CDC) Proposed Sponsoring Groups Structured Documents Work Group (Primary) Public Health Work Group (Co-sponsor) Orders and Observation Work Group (Co-sponsor) Pharmacy (Co-sponsor)

Project Proposal: Preliminary Project Plans Project Scope Statement Develop, vet, and gain approval for a Scope Statement Anticipated Project Tasks Gather data requirements from clinical and public health subject matter experts Analyze a sample of data that have been sent using the current C-CDA standards Identify and specify optional additions to the C-CDA Continuity of Care Document and Discharge Summary designed to fulfill data requirements Identify or develop value sets for proposed additions to C-CDA documents Assemble and submit C-CDA document additions as a ballot proposal, e.g., a proposed set of optional templates, and respond to ballot comments Secure HL7 organizational approval Develop plans for maintaining and supporting use of the optional additions to C-CDA documents

Thank You!