1. Public Health Data Standards Consortium http://phdatastandards.info http://phdatastandards.info

2. 1 PUBLIC HEALTH DATA STANDARDS CONSORTIUM ~ 2005 BUSINESS MEETING OF MEMBERS ~ May 24, 2005, Washington DC Report on the Consortium’s Activities Anna O. Orlova, PhD Executive Director

3. 2 PHDSC – Membership Structure 2004 2005

4. 3 PHDSC Activates on Electronic Health Record (EHR) Dec-March 04PHDSC Ad Hoc Task Force on Electronic Health Record-Public Health (EHR-PH ) to validate Health Level 7(HL7) EHR Functional Model July-Dec. 04Pediatric EHR – Public Health Perspectives. Contract from HRSA Jan-Feb. 05Demonstration of Interoperability Across Clinical and Public Health Systems via EHR, HIMSS-2005

5. 4 WHITE PAPER on Electronic Health Record: Public Health Perspectives (EHR-PH) March 2004 Purpose: (1) to communicate to the public health community a need for broader involvement in the national effort to standardize clinical and public health data and information systems, and (2) to describe public health perspectives on the EHR. PHDSC Ad Hoc Task Force on Electronic Health Record-Public Health (EHR-PH)

6. 5 Goal is to contribute to the definition of and development of the pediatric EHR from public health perspectives (PEHR-PH). The PEHR-PH is seen as a two way clinical and public health information interchange for the purpose of providing the best health care service to children. PHDSC Project on Pediatric Electronic Health Record-Public Health (PEHR-PH) Funded by HRSA

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8. 7 Cross-mapping of Clinical and Public Health Data ROUTINE VISITS OF WELL CHILD CARE; AGE 0-6mos and at 5y u 8 CLINICAL FORMS (Hospital of Birth; Outpatient Pediatric Clinic – Johns Hopkins Hospital) u 7 PUBLIC HEALTH FORMS (State Health Department – Maryland State Department of Health and Mental Hygiene) 1 st Newborn Metabolic Screening Hearing Screening Immunization Birth Defect Form Vital Registration 2 nd Newborn Metabolic Screening Child Health Inventory (5 years of age)

9. 8 Cross-mapping of Clinical and Public Health Pediatric Data u Clinical system is a significant source of data for pediatric public health systems u 59% data concepts used in clinical care maps to public health data needs u Significant redundancy can be overcome if EHR systems will populate public health programs

10. 9 Current Workflow for Data Interchange between Primary Care and Public Health Patient Health Care ProviderPublic Health Agency Newborn Screening Registry Receive the form Verify data on the form Enter data to PH DB Verify data entry Manage data in PH DB Analyze data Create the form Patient Record Record data on the form Verify data on the form Enter data to PH DB Verify data entry Manage data in HCP DB Generate reports Create the form Immunization Registry Receive the form Verify data on the form Enter data to PH DB Verify data entry Manage data in PH DB Generate reports Create the form Hearing Registry Receive the form Verify data on the form Enter data to PH DB Verify data entry Manage data in PH DB Generate reports Create the form Communicable Disease Registry Receive the form Verify data on the form Enter data to PH DB Verify data entry Manage data in PH DB Generate reports Create the form Generate reports Analyze data - Actions related to services - Actions related to data management

11. 10 EHR-based Workflow for Data Interchange between Primary Care and Public Health Patient Health Care ProviderPublic Health Agency Newborn Screening Registry Analyze data Retrieve Data from EHR DB Generate reports Create the form EHR System Record data on the form Verify data on the form Enter data to HCP DB Verify data entry Manage data in HCP DB Create the form Immunization Registry Create the form Hearing Registry Create the form Communicable Disease Registry Create the form Analyze data Retrieve Data from EHR DB Generate reports Analyze data Retrieve Data from EHR DB Generate reports Analyze data Retrieve Data from EHR DB Generate reports - Actions related to services - Actions related to data management Generate reports

12. 11 Public Health Vision for Interoperability across Different Systems: Building EHR-PH System Prototype Public Health Newborn Screening Program Hearing Screening Program Immunization Program Clinical Care Communicable Disease Reporting Program EHR-PH DATA EXCHANGE Newborn Screening Registry Hearing Screening Registry Immunization Registry Communicable Disease Registry Patient Personal Health Record Health Care Provider 2 Health Care Provider 3 Health Care Provider 1 Laboratory

13. 12 Clinical Care ADT- Birth Record Newborn Screening Test Hearing Screening Test Immunization Administration External Laboratory Hospital of Birth HL7 2.4 HL7 3.0 HL7 2.4 Public Health EHR-PH Info Exchange Newborn Screening Registry Hearing Screening Registry Immunization Registry Communicable Disease Registry State Health Department HL7 3.0 HL7 2.4 J2EE PHDSC EHR-PH System Prototype for Interoperability of Clinical and Public Health Systems, HIMSS-2005 Source: Orlova, et al. HIMSS 2005,Dallas TX, February 13-17, 2005

14. 13 EHR-PH System Prototype for Interoperability in 21st Century Health Care System Our Prototype illustrates how interoperability between healthcare systems can be achieved with a standards-based infrastructure Is built upon existing systems in clinical care and public health programs Enables electronic data reporting from a clinical setting to multiple public health systems Enables translation of customized standards into HL7 3.0 messaging standard Links clinical and public health systems to provide a continues view of the patient record across the systems involved

15. 14 Slide 14 EHR-PH Demonstration: Partners DESIGN DEPLOYMENT Slide 14 ¤ NEWBORN SCREENING ¤ HEARING SCREENING ¤IMMUNIZATION ¤COMMUNICABLE DISEASE REPORTING

16. 15 Slide 15 EHR-PH Demonstration: Design Development u Laboratory u NEDSS Comparability CDC

17. 16 Acknowledgements u Dr. David Ross, Director, Public Health Informatics Institute Health Resources and Services Administration (HRSA) u Ms.Jessica Townsend and Dr. Michael Millman, Office of Planning and Evaluation & u Dr. Marie Mann, Genetic Services Branch, Maternal and Child Health Bureau Technical Panel u Dr. David Hollar, University of Tennessee Graduate School of Medicine u Dr. Harold Lehmann, Dept. of Pediatrics, Johns Hopkins Medical Institutions u Dr. Christoph Lehmann, Dept. of Neonatology, Johns Hopkins Medical Institutions u Dr. Susan Panny, Director, Office of Genetics and Children with Special Needs, Maryland State Department of Health and Mental Hygiene u Dr. Phillip Gioia, President, Children Health Specialists, Inc., and Cayuga County Health Department u Dr. Paul Biondich, Regenstrief Institute, Inc. and Department of Children’s Health Services

18. 17 Acknowledgements EHR-PH Demonstration u Ms. Michelle Williamson, National Center for Health Statistics u Dr. Michael Higgins and Mark Dunnagan, Oracle u Dr. Allen Tien and Steven Beales, Medical Decision Logic, Inc. u Drs. Terese Finitzo and Ken Pool, OZ Systems u Mr. Todd Watkins, Science Technologies Corporation Special Thanks to u Dr. Steven Steindel, Centers for Disease Control and Prevention u Dr. Eillen Koski, QuestDiagnostics, Inc.

19. 18 RESPONSE TO THE REQUEST FOR INFORMATION on the Development and Adoption of a National Health Information Network from the Office of National Coordinator for Health Information Technology (ONCHIT), Department of Health and Human Services; Released on November 15, 2004 PHDSC Committee on a National Health Information Network Submitted to ONCHIT on January 18, 2005