Ways, not places: Death certification from an EHR Jeff Duncan, MS Utah Department of Health.

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Presentation transcript:

Ways, not places: Death certification from an EHR Jeff Duncan, MS Utah Department of Health

in 1992…Places America Online MCI Compuserve Phil Windley 2012

now SMTP

Evolution of Health IT …Places BillingEHRRx Laboratory (LIS) Radiology (RIS) EDRS

Integrated Delivery systems such as Intermountain Healthcare…Ways EHR Laboratory (LIS) Radiology (RIS) DOH Payers Health Information Exchange (HIE) Rx Billing Clinical Workstation Others Internal Communications External Communications HL7HL7 HL7HL7 HL7HL7 *Reportable Diseases * Immunizations *Syndromic Surveillance HL7HL7 *Death Certification

What is HL7? HL7 is… – An ANSI standards organization – A family of standards for exchanging health information HL7 v2 Message:

What is in the DSTU? Message Structures – ADT^04—Add – ADT^08--Update – ADT^23--Delete Message Contents – Demographic fields for matching – Cause of death fields from death certificate Constraints – Which fields are optional, which fields are required Value sets—what values are allowed

Intermountain’s EHR screen:

CDC Pan Flu Grant UDOH received funding to create a death reporting interface with Intermountain. Pilot testing Implemented at one Intermountain Clinic HL7 Version 2.3 Interface Planning and Development Interface development and testing DSTU Implementation Pilot test expanded to Salt Lake City Metro Area Timeline of events—UDOH-Intermountain Death Interface 2010 Upgrade to DSTU Project begins HITECH act and Meaningful Use

Certification Process Business Rules -matching and merging -update / delete messages

Advantages of certification through EHR For Physicians: No need to remember login and password to EDRS Access to relevant clinical data Potential for clinical decision support For Public Health: (hypothesis)Engaging physicians within their workflow in the EHR will: Improve timeliness, completeness and accuracy of death data Engage more physicians in electronic death registration

Challenges Ensure data semantic standards meet the needs of public health Ensure standards are flexible to meet the unique needs of individual jurisdictions Ensure data quality standards are met or exceeded

Next Steps DSTU implementatio n (July, 2013) Testing for one year Provide feedback to HL7 (July, 2014) HL7 ballots and approves normative standard Industry implements standard.

Acknowledgements NCHS – Michelle Williamson Intermountain Healthcare Team – Jacob Tripp, PhD Utah Department of Health – Leisa Finch, EDR Coordinator Multidimensional Software Creations (MDSC) – Stephen Clyde, PhD – Mike Jolley, Project Manager

Questions? Jeff Duncan, MS Public Health Informatics Program Manager Office of Public Health Informatics Utah Department of Health