1. Public Health Case Reporting Workflow Brief Profile Proposal for 2010 - 2011 presented to the QRPH Planning Committee John P. Abellera, MPH September 29, 2009

2. QRPH Planning Committee The Problem Public health case reporting is paper-based, labor intensive and slow Legal perspective: Regulations vary by jurisdiction; lack of consensus on data elements for reporting and detection Healthcare provider perspective: Clinicians and staff time and effort constraints Public health perspective: Laboratory report does not provide clinical, treatment, or (often) demographic information required for disease surveillance purposes Technical challenges: No national standard (AHIC) or certification (CCHIT) for electronic case reporting has yet been established

3. QRPH Planning Committee Use Case 1. 1.Publish the reporting criteria – –Public health knowledge about reporting criteria  clinical and lab systems 2. 2.Case Identification – –Laboratory reports  public health electronic disease surveillance system – –Clinical case reports (both electronic and non-electronic)  Public health electronic disease surveillance system 3. 3.Case Investigation – –Case investigation following-up on the clinical case report and laboratory reports (both electronic and nonelectronic): 4. 4.Health Status Information, e.g., outbreak notification and surveillance data, health status trend and rates – –Population health data needed for clinical decision-making

4. QRPH Planning Committee Proposed Standards & Systems 1. 1.Local and state disease surveillance systems, including National Electronic Disease Surveillance System (NEDSS) and PH registries (e.g., cancer registries, immunization registries, newborn screening registries) 2. 2.Electronic Health Records (EHR), Electronic Medical Records (EMR) and Personal Health Records (PHR), Laboratory Information Systems (LIS), and Hospital Information Systems (HIS) 3. 3.Outbreak, PH case detection, and PH case management systems 4. 4.Transport mechanisms: IHE ITI Profiles, PHIN Messaging Solution (PHIN-MS), NHIN gateway 5. 5.Messaging standards, including HL7 v2.x and HL7 Clinical Document Architecture (CDA) 6. 6.Terminology standards, including LOINC, SNOMED, PHIN-VADS, HL7, ICD-9, ICD-10

5. QRPH Planning Committee Discussion Based on the IHE – PHDSC White Paper entitled “Building a Roadmap for Health Information Systems Interoperability for Public Health”, 2008 Help develop a coordinated approach for developing public health profiles at IHE Inform the development of the Technical Framework for the Quality, Research and Public Health (QRPH) Technical Committee.