Public Health Reporting Initiative July 25, 2012

Agenda TopicTime Allotted Welcome / Agenda Overview – Lindsay Brown4:00 - 4:05 Public Comment Update – Lindsay Brown4:05 – 4:10 Data Harmonization – Nikolay Lipskiy Definitions Impact Approaches 4:10 – 4:40 Stage 3 Sprint – Seth Foldy4:40 – 4:50 Discussion / Action Items4:50 - 5:00 Adjourn5:00

Public Comment Functional Requirements Document and Data Elements for User Stories have been posted for public comment on the PHRI wiki: To provide comments: – Use the discussion boards linked to on the wiki page (note: instructions for using discussion boards are included as well) – Lindsay Brown with additional Please feel free to forward the request for comment to others

7/117/187/258/18/88/158/22 8/29…9/26 Public Comment & Consensus on Functional Requirements and Domain-level Data Elements Timeline Develop ‘core’ data elements for PH reporting Develop Implementation Specification, focusing on PH reporting scenarios that are ready for Stage 3 of Meaningful Use Develop ‘core common’ data elements Ongoing identification, maintenance, and harmonization of data elements, vocabularies, and standards for public health reporting (beyond Stage 3 of MU) Ongoing modeling of PH reporting data elements Stage 3 Pilot Planning

Data Harmonization Working to develop definitions for data element classifications – Assessing impact of these data element classifications to stakeholders Working to develop an approach to identifying core common data elements Goal: By the end of the week, propose a set of core common data elements to the Stage 3 Sprint Workgroup for consideration as they develop an Implementation Guide

Public Health Report – Data Element Classifications Implementation specific elements Report type specific elements Core common elements Specific to local or program- specific elements Minimized in favor of report type specific elements Harmonized when possible** Reused when appropriate Harmonized* Highly reused by many reports across several domains *Harmonizing these elements is a top priority – work is in progress ** Harmonizing these elements is a secondary priority – dependent on availability

Core Common Data Elements Harmonized data elements that are widely shared across several report types – Expect EHR systems to be able to produce these data elements (e.g., under MU Stage 3 certification criteria) – PH systems may or may not consume these data elements, based on their specific requirements (but they will be available for inclusion in reports to PH) – Primary focus for PHRI at this time: harmonizing and identifying the core common data elements for a provider-initiated report from an EHR system to a public health agency system Work is in progress – Data Harmonization Profile (estimated completion: beginning of August 2012) Impact – Legislative (MU S2 & S3): Include in MU certification criteria for PH reporting, updating test procedures and conformance rules – EHR vendors: Products must support these data elements and interfaces to support PH reporting – PH Information System vendors: Products meet requirements of PH program. Should be aware of what is available in EHR for inclusion in PH report, and potentially PH system. – S&I PHRI: Primary content for harmonization across all PH domains (i.e., focus of Data Harmonization Profile) – National and State PH Programs: Primary focus of cross-domain harmonization

Report Type Specific Data Elements Harmonized data elements that are broadly required across public health for a particular report type (e.g., communicable disease case report, birth record report, etc.). – Special effort is also taken to harmonize elements between different report types in a given domain but differences may exist when necessary. For example, harmonization across case reporting and syndromic surveillance within the communicable disease domain – Report type is at a higher level than “user story” but is a subset of “domain”. For example: User Story: TB reporting in California Report Type: Case Reporting Domain: Communicable Disease – Harmonizing data elements at the report type level is a secondary focus of the PHRI at this time – work will begin based on availability constraints after the core common data elements are harmonized Expectation is that these ‘report type’ specific data elements will be sent to public health agencies at the same time as the core common set of data elements (more detail will be provided in the implementation specification) Impact – Legislative (MU S2 & S3): Include for domain-specific MU objectives developed directly by programs (e.g., HAI, Cancer), updating test procedures and conformance rules – EHR vendors: Support these data elements and/or interfaces – PH Information System vendors: Products meet requirements of PH program. Should be aware of what is available in EHR for inclusion in PH report, and potentially PH system. – S&I PHRI: Secondary level of content to harmonize within domains – future step – National & state PH programs: Secondary to cross-domain harmonization

Implementation Specific Data Elements Additional relatively unique, or non-harmonized, elements required by a particular jurisdiction or public health program (e.g., TB report in California) – Data elements may be unique to the sender/receiver workflow or requirements and may require manual data entry by the healthcare provider to complete the report – Data elements may not be part of the EHR requirements in MU Goal is to attempt to minimize the number of implementation specific data elements for each public health report Impact – Legislative (MU S2 & S3): May not be part of EHR requirements in MU – EHR vendors: Encouraged to support, but requires continual monitoring and understanding to determine if alignment and inclusion is possible Potential CMS requirement to accommodate jurisdictional specificity that should be reflected in products – PH Information System vendors: Products meet requirements of PH program. Should be aware of what is available in EHR for inclusion in PH report, and potentially PH system. – S&I PHRI: Contribute to understanding of implementation. Will support based on resource availability; first priority will be the implementation-specific data elements included in the Stage 3 Sprint implementation guide – National & state PH programs: contribute to understanding of elements

Identifying “Core Common” Data Elements Standards Analysis approach to identify similar data elements across user stories – Individual data elements within specific user stories were analyzed to determine where 2 user stories included the same concept – For example: User Story 1 Patient Name = User Story 2 Report Subject Name Defining “common” – Data Element shared by 3+ user stories – Data Element shared by 2+ domains – Data Element shared by 3+ domains Next steps – Thursday Data Mapping Call (12-2 PM EST): Select an approach and propose a set of ‘core common’ data elements – Homework to Stage 3 Sprint group: Review proposed set of ‘core common’ data elements to identify any gaps, questions, concerns – Stage 3 Sprint group: Make any modifications to the ‘core common’ data elements, in conjunction with Data Mapping group, to support the development of an implementation specification

Stage 3 Sprint – Implementation Guide Focused on stories that are ready for Stage 3 Kick-off July 26, 2012, 2-4 PM EST Lindsay Brown with