Incorporating Health Data from Electronic Health Record Systems and Administrative Data Sets into Public Health Systems for Administrative Uses – A Landscape Analysis and Guidance Document Detailed Profile Proposal for 2011/12 presented to the Quality, Research & Public Health (QRPH) Planning Committee Sarah Quaynor Bob Davis Anna Orlova November 11, 2011

Quality, Research & Public Health (QRPH) Planning Committee The Problem No integration across EHR systems, public health registries, quality measurements registries for health data exchanges for administrative useNo integration across EHR systems, public health registries, quality measurements registries for health data exchanges for administrative use Relevant data: includes hospital discharge data, claims data, billing records sent to the state – Needs definitionRelevant data: includes hospital discharge data, claims data, billing records sent to the state – Needs definition Administrative uses: evaluate patient safety, monitor the occurrence of disease, assess health resources, identify services, monitor environmental conditions.Administrative uses: evaluate patient safety, monitor the occurrence of disease, assess health resources, identify services, monitor environmental conditions.

Quality, Research & Public Health (QRPH) Planning Committee The Problem Many public health programs working independently on topicMany public health programs working independently on topic –Diabetes –Cancer Registries –AHRQ (Agency for Healthcare Research and Quality) –NAHDO (National Assoc. of Health Data Organizations) RISK - if this proposal is not undertaken this cycleRISK - if this proposal is not undertaken this cycle –Continued development of discrepant standards –Duplication of work effort with duplication of resources –Fragmented implementation based on patient population

Quality, Research & Public Health (QRPH) Planning Committee Use Case Patient visits Provider with symptoms indicating communicable disease. Visit data recorded in patient’s medical record (paper or electronic) Visit data recorded in EHR Provider orders lab test. Test order is recorded in medical record. Order recorded in EHR Specimen is collected & sent to lab. Lab conducts test & records results in LIMS CURRENTSOLUTION

Quality, Research & Public Health (QRPH) Planning Committee Use Case (contd.) Health data for administrative and financial use added to medical record - may need to be exchanged with PH agencies Lab sends result to Provider Received into EHR Provider reviews & confirms diagnosis. Identifies patient for reporting to PH agency EHR pre-populates initial PH report form & sends notification Provider authorizes report submission to PH-SS Directly from EHR, or via HIE PH staff receive report PHSS sends acknowledgement to EHR/HIE CURRENTSOLUTION

Quality, Research & Public Health (QRPH) Planning Committee Proposed Standards & SystemsSYSTEMSSTANDARDS APCD’s ASC X12 Messaging Stds EHR-SNUBC HIE HL7 (vocab, CDA R2, v2.x) LIMS IHE Sharing Value Sets PH-SSPHIN-VADS Payer Systems IHE PIX & PDQ State Data Collection Systems HL7 PH Reporting Reqs Systems for assembly of health data for administrative uses Other data stds for exchanges of health data for admin use

Quality, Research & Public Health (QRPH) Planning Committee Process & Deliverables 1.Common definition of administrative use of health data 2.Relationship between EHR-S, State Data Collection Systems, Public Health agency systems - Deliv. #1 3.Inventory of data elements currently collected in the Hospital Discharge Data Set 3.Inventory of data elements currently collected in the Hospital Discharge Data Set 4.Inventory of state-specific data elements/program specific data elements and what is needed by public health - Deliv. #2 & #3

Quality, Research & Public Health (QRPH) Planning Committee Process and Deliverables (contd.) 5. Analysis and Recommendations for identifying and collecting health data for administrative use (Deliv. #4) Strategic PlanStrategic Plan Recommendations for:Recommendations for: –Data source - from EHR or other administrative data set systems –Resolution of data gaps –Generic content module –Adding data to the Uniform Billing standards (ASC X12) –Consistency in patient demographic fields (names, addresses, DOB, SSN) - and use of MPI

Quality, Research & Public Health (QRPH) Planning Committee Effort Estimates QRPH Technical Committee Support Event Time allotment Support QRPH Conf Calls WG report q2 weeks Provide feedback and suggestions One week prior to F2F 2 hours Review profile in preparation for F2F QRPH F2F minutes sessions Provide feedback and suggestions Public Comment Review 2 – 90 minute sessions Provide feedback and suggestions Admin Data White Paper Work Group Event Time allotment WG Conf Calls 90 minutes q 3 weeks Offline work 2 hours /week QRPH F2F Attend meetings below via conference call Admin Data White Paper Work Group Participants PHDSC (Profile Editor) HL7 Diabetes Strategy Project NAHDO (National Association of Health Data Organizations) CDC / NCVS? NAACCR (North American Association of Central Cancer Registries) CDC-NPCR (National Program of Cancer Registries Registry Widgets

Quality, Research & Public Health (QRPH) Planning Committee QUESTIONS??