1. Using Messaging Workbench for National Case Reporting: Status Update, Challenges, Lessons Learned
Margaret Marshburn, RN, BSN, MSHS
PHIN Messaging & Vocabulary Standards
Division of Informatics Shared Services
National Center for Public Health Informatics

2. Agenda Introduction Planning for Change Challenges Current Status
Lessons Learned
Questions?

3. Message Implementation Package
A group of artifacts that together constitute all the information necessary to implement a message
Implementation
Package
Messaging Use Case
Message Structural Spec (or Profile)
Message Mapping Guide
Messaging Vocabulary

4. A Message Profile is a Contract for Implementation
Specifies implementation constraints
Must be compliant with the HL7 standard
Describes the static structure of the message:
Segments in use
Fields in use
Implied data validation rules
Reduces interface analysis time by clarifying interpretation of the standard

5. Agenda Introduction Planning for Change Challenges Current Status
Lessons Learned
Questions?

6. Specifications/Profiles in use for National Case Reporting
National Condition Reporting Message
National Notification Associated Laboratory Report Message (optional)
National Notification Associated Vaccine Report Message (optional)
PHIN Batch Messaging Profile (optional)

7. Functions of Messaging Workbench (MWB)
Provides standard HL7 message definitions
Provides user interface for building profiles
Facilitates reuse of profiles
Allows registration of profiles with HL7
Creates XML and HTML reports

8. Messaging Workbench

9. MWB – Load Message Structure

10. MWB – Standard Message Definitions

11. MWB – Datatype Maintenance

12. MWB – Library Maintenance

13. MWB – Table Maintenance

14. MWB – Profile Submission

15. MWB Development Activities
Created the following MWB files:
PHIN Datatype library
PHIN Table Library
PHIN Base Segment Library
PHIN Demographic Segment Library
PHIN Clinical Segment library
Created macros to facilitate HTML import to Word
Changed the stylesheet (.xsl) for report presentation
Documented instructions for library management

16. Agenda Introduction Planning for Change Challenges Current Status
Lessons Learned
Questions?

17. Messaging Team Experience
Free training classes
Not well documented
Not intuitive
Often need to revisit the basic building blocks in order to make changes
Defects in certain functionality
MWB output is segment attribute tables
Requires a technical writer
Much more time consuming

18. MWB Segment Detail Format

19. Legacy Segment Detail Format

20. MWB XML Profile <?xml version="1.0" encoding="UTF-8"?>
<Specification SpecName="PHIN National Case Notification Profile" OrgName="CDC NCPHI" HL7Version="2.5" SpecVersion="1.7" Status="Draft" ConformanceType="Constrainable" Role="Sender" HL7OID="" ProcRule="HL7">
<Conformance AccAck="NE" AppAck="AL" StaticID="{ConfSig(1) CDC NCPHI(1) null(0) static-profile(1) null(0) null(0) null(0) (1) 1.7(1) Sender(1)}" DynamicID="{ConfSig(1) CDC NCPHI(1) null(0) dynamic-profile(2) AccNE_AppAL(2) defer_mode_ack(1)}" MsgAckMode="Deferred" QueryStatus="Event" QueryMode="Non Query"></Conformance><Encodings><Encoding>ER7</Encoding></Encodings>
<Message MsgType="ORU" EventType="R01" OrderControl="N/A" EventDesc="" Structure="MSH,PID,OBR,OBX" MsgStructID="ORU_R01">
<Segment Name="MSH" Description="Message Header - The Message Header Segment (MSH) contains information describing how to parse and process the message. This includes identification of message delimiters, sender, receiver, message type, timestamp, etc." Optionality="R" Sequence="1" Repeatable="False" Min="1" Max="1" Reference="" Predicate="" >
<Field Name="Field Separator" Description="" Optionality="R" Sequence="1" Repeatable="False" Min="1" Max="1" ItemNo="00001" Datatype="ST" Length="1" Reference=" " Predicate="" >
<ImpNote>
<Paragraph>The supported value is |, ASCII (124).</Paragraph>
</ImpNote>
<HL7Definition>
<Paragraph>Character to be used as the field</Paragraph>
<Paragraph>separator for the rest of the message.</Paragraph>
</HL7Definition>
<DataValues ExValue="|" Regex="^[\x20-\x7e]{1,199}$"/>
</Field>
<Field Name="Encoding Characters" Description="" Optionality="R" Sequence="2" Repeatable="False" Min="1" Max="1" ItemNo="00002" Datatype="ST" Length="4" Reference=" " Predicate="" >
<Paragraph>Four characters, always appearing in the</Paragraph>
<Paragraph>same order: |^~\&|.</Paragraph>
<DataValues ExValue="^~\&" Regex="^[\x20-\x7e]{1,199}$"/>
<Field Name="Sending Application" Description="" Optionality="R" Sequence="3" Repeatable="False" Min="1" Max="1" ItemNo="00003" Datatype="HD" Length="224" Reference=" " Predicate="" >
<Paragraph>Field used to uniquely identify the sending</Paragraph>
<Paragraph>application for messaging purposes.  It</Paragraph>
<Paragraph>must contain an OID that represents the</Paragraph>
<Paragraph>sending application instance.</Paragraph>

21. Agenda Introduction Planning for Change Challenges Current Status
Lessons Learned
Questions?

22. Current Status Back to old method of producing specs
Still have the Implementation Package:
Messaging Use Cases
Message Mapping Guide
Messaging Vocabulary
Message Profile/Structural Specifications

23. Agenda Introduction Planning for Change Challenges Current Status
Lessons Learned/Questions

24. Lessons Learned “Change is hard work” Need more resources
Need more support from outside groups

25. Questions?