1. 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 IHE Connectathon Testing
Feb 2012 – HIMSS Showcase (Lab/case reports for TB, HAI)
January-April 2012 – Development
May Pilot

2. 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:
Public Health Case Reporting (from EMR - HIV or TB or Morbidity Report)

3. 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

4. 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 (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

5. PH Reporting Technical Framework

6. 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

7. PH Communication Server4 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

8. 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

9. 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)

10. 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

11. 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

12. HIMSS Interoperability Showcase: Public Health Reporting Use Case3 1 2
Scope: 1,2,3

13. 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