CDA State Pilot Project: Timeframe Nov-Dec 2011 – Recruitment and Pilot Design DE (DHIN, DHIE, DPH) HAI reporting via NHSN (national health & safety network)? CA? (Atlas Public Health) Greenway Technology Oz Systems Jan 2012- IHE Connectathon Testing Feb 2012 – HIMSS Showcase (Lab/case reports for TB, HAI) January-April 2012 – Development May 2012- Pilot

Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH): Proposed Public Health Programs for CDA for PH Pilot Project: Biosurveillance (with focus on laboratory data for influenza; and reporting decisions) Cancer Early Hearing Detection and Intervention (EHDI) Electronic Laboratory Reporting TB HepB Flu Antrax Tularemia Electronic Case Reporting (provider to local/state PH; and local/state PH to CDC) Plus 10 other conditions See CDA for Public Health Wiki Page: URL: https://wiki.phdsc.org/index.php/PH-Lab#PH-CDA_Templates_Work_List Public Health Case Reporting (from EMR - HIV or TB or Morbidity Report)

Action Items Statement of Work for Participating State(s) – 12/15 (Mark, Anna, Marshall, Terese, Nitin, Lisa) DE Interoperability Model Pilot Scenario(s) (Lisa, Jib) Criteria for selecting conditions (standards are ready to go, morbidity/mortality prevalence, other) Conditions – to be decided by CSTE and States - 12/15 HIMSS Demo Scenarios – 11/28 CDA Templates – Initial 02/2012 (Sondra, Mark, Marshall, Anna, Nitin) TB, HAI (Atlas!) Technical Advisory Group (TAG) for State Implementations Define challenges to address APHL TAG for PHLIP as examples Advisors: Nitin (Oz Systems), Atlas, DE, Sondra’s team, Calls schedule: Dec 2 1-2pm ET. Every Other Friday 2-4 starting 12/9 Outreach/Communication Plan for the Project – Ongoing – Maiko/CSTE/APHL

For TAG Leader Pilot Overview Document explaining the pilot to be replicable in other states and domains – May 2012 Outline= IHE Volume 1 Write-Up or IHE PCC Workflow Profile 2011-2012 (ereferal and telemonitoring) – Draft 1/16 State Specific Description - Draft 2/28 Design the Pilot Architecture diagram State Specific Diagrams - Draft 2/28 Recruit/Form state pilot workgroups Identify/recruit senders-receivers vendors, PH programs, IT support for actual site (DE, CA, TX, WI, CT; HISPC 10state project model) Define roles of the TAG members in the pilot and unintended consequences Work with state pilot workgroups to execute the pilot test – invite APHL PHLIP TAGs and others – Flu Labs Align with other pilots in PH and with S&I PH Reporting Pilots

PH Reporting Technical Framework

PH Communication Server Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH): Proposed State-based Pilot Project Schema : Scope: 1,2,3 2 Case Report HIE Or PH Communication Server For HL7 2.x messages: Rhapsody to translate 2.x messages and CDA For CDA: RFD NHIN Connect XDS DSUB NAV Pseudonymize 3 Case Report 1 Provider EHR Local or State PH Program IS Test Order Test Result Test Result Case Report Test Order laboratory LIMS CDC PH Program IS Test Result Test Result

PH Communication Server 4 2 HIE Or PH Communication Server For HL7 2.x messages: Rhapsody to translate 2.x messages and CDA For CDA: RFD NHIN Connect XDS DSUB NAV Pseudonymize Case Report 3 Case Report 1 Provider EHR Local or State PH Program IS Test Order Test Result Test Result Case Report laboratory LIMS Test Order CDC PH Program IS Test Result Test Result

Delaware PH Communication Server/Router Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Schema: DELAWARE Provider EHR (Core CX360) CCD Content to Pre-populate TB Case Report Form Manager (OZ) CDA TB Case Report Delaware PH Communication Server/Router (Orion Rhapsody) CDA TB Lab Report Laboratory LIMS (Labware) CDA TB Lab Report

Content to Pre-populate Pertussis Case Report Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Schema: SAN DIEGO CCD Content to Pre-populate Pertussis Case Report Provider EHR (?) HIE / Form Manager? (?) CDA Pertussis Case Report San Diego PH System (Atlas)

Proposed Pilot Project Schema: NEW YORK STATE Clinical Document Architecture Standard for Public Health (CDA for PH): Proposed Pilot Project Schema: NEW YORK STATE CCD Content to Pre-populate Pertussis Case Report Provider EHR Connexin Medent Form Manager (?) NYS PH System UPHN, Rochester RHIO (Axolotl) THINC (GSI) Pertussis CDA Case Report

User Story: State-Specific Story, Condition-Specific, Setting Specific User Story Names: Communicable Diseases, Outpatient Flow Patient, Provider/Physician, Laboratory, PH agency Patient comes to Physician with symptoms of a disease. Physician provides clinical examination and assesses medical history. If patient’s symptoms require PH reporting w/o waiting for lab results, sends a report to PH agency. Physician orders lab and any diagnostic tests. Office staff takes samples and sends them to Laboratory. Any diagnostic tests are performed. Laboratory performs ordered tests on received specimens. Laboratory send results to Physician and PH agency (if needed) Physician re-examines clinical findings/diagnostic results and lab results; sends report to a PH agency. Electronic message validated by PH agency/information system Electronic confirmation was sent from PH agency to Provider PH agency links lab report and case report to single individual. Actors: Flow of Events: Pre-condition EHR System Post-condition Public Health Agency’s Information System Preferred Timing for Each Event Type

HIMSS Interoperability Showcase: Public Health Reporting Use Case 3 1 2 Scope: 1,2,3

PH Communication Server Clinical Document Architecture (CDA) Standard for Public Health (CDA for PH): Proposed State-based Pilot Project Schema Case Report HIE Or PH Communication Server For HL7 2.x messages: Rhapsody to translate 2.x messages and CDA For CDA: RFD NHIN Connect XDS DSUB NAV Pseudonymize Case Report Provider EHR Local or State PH Program IS Test Order Test Result Test Result Case Report Test Order laboratory LIMS CDC PH Program IS Test Result Test Result