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

Public Health Data Standards Consortium CDA EHDI Pilot Project Clinical Document Architecture (CDA) for Public Health CDA State EHDI Pilot Projects

CDA EHDI Pilot Project: Timeframe Aug - Sept– Recruitment ✔ 2 State participants (To be determined) X State observers (To be determined) November/December 2012 – Pilot Design  January/February 2012 – Implementation January 31/February 28, 2012 – Testing March, 2013 – Draft Project Report May 2013 – Final Project Report

CDA EHDI Pilot Project: Next Steps FOR PARTICIPANTS Finalize recruitment of vendor partners – by Dec 14 Confirm system capability to send/receive report Ready State Team for weekly calls (Staff and System Vendors) Confirm data requirements – by Jan 4 Define architecture for reporting Participate in design calls Confirm report meets EHDI program requirements

CDA EHDI Pilot Project: Next Steps FOR PHDSC TEAM By Dec 14th Announce results of technical assessment and selection of Pilot Participants Setup and hold weekly State Technical Team Pilot Implementation meetings Finalize State technical capabilities and secure vendor commitment Complete NHS data model By Jan Call Define State-specific architecture for data reporting Harmonize and confirm State-specific data requirements/schema Define State-specific pilot timelines and work plan Start development of State projects designs  Educate Participants and Observers about Model Driven Health Tools (MDHT)

State Work Plan Task Point of Contact Due Date Conduct data mapping from CDA NHS Outcome Report model to EHR Data/Form PHDSC, State Team TBD Identify program data requirements State Team Complete data/code mapping PHDSC Create NHS form in EHR EHR vendor Create CDA NHS Outcome Report from Form Data in EHR Transmit CDA NHS Outcome Report directly or through HIE HIE vendor Import CDA NHS Outcome Report into PH EHDI IS PH EHDI IS vendor Test implementation PHDSC, State Team, Vendors

CDA EHDI Pilot Project: State-Specific Use Case Newborn Hearing Screening Newborn, Caregiver, Clinicians, Public Health Program Staff EHR, HIE, Public Health (PH) EHDI IS Actors: Business Actors Technical Actors Data Categories Child is delivered. Clinician conducts initial physical exam Newborn is due for <hearing test> Clinician orders an <hearing test> Hospital staff conducts <hearing test> Hospital staff enter data on the <hearing test> in the EHR database and generate <Newborn Hearing Screening (NHS) Outcome Report> Information is electronically sent on <NHS Outcome Report > to the PH EHDI IS directly or via HIE PH program EHDI IS receives Notification of Report Availability PH programs’ staff reviews the report and create PH EHDI IS record on a child in PH EHDI IS and upload <NHS Outcome Report > in PH EHDI IS PH IS sends Acknowledgement of Receipt of the Report to EHR directly or via HIE. 1&2. Demographics, Labor & Delivery Record, Newborn EHR 3. Consent 4. Standing Order 5. Hearing Test Results 6. Hearing Test Results, NHS Outcome Report 7. NHS Outcome Report 8. Notification of Report Availability 9. Updated Pubic Health EHDI Record 10. Acknowledgement of Receipt Flow of Events Pre-Conditions: EHR System, Health Information Exchange (HIE) Post-Conditions: Public Health Information System <EHDI IS> Preferred Timing Daily updates

Oregon - EHDI Reporting Design Birthing Facility EHR OHSU, Legacy Health (Epic 2012) Public Health Gateway (TBD) State EHDI Information System Oregon (Orion Rhapsody, Locally Developed) Continuity of Care Document (CCD) CDA NHS Outcome Report Continuity of Care Document (CCD) Form Filler Form Manager Form Receiver Or Other CDA Document (Labor & Delivery Summary) Form Key: CCD: Continuity of Care Document CDA: Clinical Document Architecture OHSU: Oregon Health & Science University NHS: Newborn Hearing Screening RFD: Retrieve Form for Data Capture Delivery of Form along with pre-population data bound to the form CDA-based Actor Diagram using RFD

North Dakota - EHDI Reporting Design North Dakota EHDI Program Birthing Facility EHR Trinity (Cerner) NANI & PCD-01 Public Health Gateway (OZ) State EHDI Information System (OZ) Early Hearing Care Plan (EHCP) PCP/ Pediatrician TBD (Greenway) Key: EHCP: Early Hearing Care Plan NANI: Newborn Admission Notification Information PCD-01: Patient Care Device - Communicate PCD Data XDR: Cross-Enterprise Document Reliable Interchange Document Reliable Interchange (XDR) CDA-based Actor Diagram using XDR