1. Brief Profile Proposal for 2014/15 presented to the Quality, Research & Public Health (QRPH) Planning Committee Lisa R. Nelson, Lantana Consulting Group (LCG) Public Health Informatics Institute (PHII) Centers for Disease Control and Prevention Office of Noncommunicable Diseases, Injury and Evironmental Health National Center on Birth Defects and Developmental Disabilities (NCBDDD) (CDC/ONDIEH/NCBDDD) October 17, 2014

2. WORLD The Market World www.ecology.com http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_02.pdf US National Vital Statistics Report

3. The Problem Assure hearing screening for all newborns Innovation is needed to improve the process: more efficient, more effective, achieve better outcomes through continuous process improvement Quality Measure standards are evolving Innovation is needed to protect prior investment, harness current/relevant technical standards-based capabilities Burden of surveillance/quality measurement is escalating Innovation is needed to reduce the burden The burden of data collection is not aligned with the benefit incenting collection of the needed data Innovation is needed to shift/align the data collection model

4. Process Value Proposition The update of the QME-EH profile will: establish a method for efficiently and effectively implementing electronic clinical quality measures (eCQM) for early hearing screening (EHDI-1a, NQF1354) which will shift the implementation model to reduce the burden of quality measure data collection and can be applied to benefit all eCQM implementations. Faster adoption of electronic CQMs, reduced cycle time for innovation, faster payoff. More data, less burden. Better alignment between bearing the burden and reaping the benefit. Process Improvement

5. Market Readiness Legislated Use Cases EHDI-1a is one of 29 Clinical Quality Measures for Eligible Hospitals Shifting focus to electronic CQM submission Meaningful Use Stage 3 will push electronic submission, eCQMs International interest in developing eCQM capability Emerging “suppliers” positioned strategically to meet the demand for eCQM support with new “combined capabilities” Benefits from investment in “data element” capabilities Additional promotional efforts EHDI community and vendors eCQM in general Emerging international implementations Assessments Conferences On-line Education

6. Existing IHE Profiles and Risks Risk of this proposal not being undertaken this cycle? IHE OPPORTUNITY COSTS Lost opportunity to establish SDO “positioning and differentiation” -IHE establishes standard methods for the application of standards -HL7 builds and maintains standards Missed chance to show “catalytic conversion competency” within IHE -IHE meets emerging standards application needs -“JIT Applied Innovation” Failure to capitalize on prior investment, leverage current assets -IHE Technical Framework creates economies of scale for standards development -More meaningful uses for existing standards

7. Use Case Current Use Case Creation of the QRDA R1.0 - Category I document Data collection/file creation burden on EMR System Proposed Use Case Creation of the QRDA R2.0 (with C-CDA R1.1 errata) - Category I and Category III documents Data collection burden eased, Utilize SDC (innovative application) Shifted to a PHIS “self-serve” model Suggest a role for Redaction Services Profile (out of scope)

8. Proposed Standards & Identified Systems HL7 CDA R2, C-CDA R1.1 CCD, QRDA R2 with errata for C-CDA R1.1, Category I and Category III QDM-based HQMF R1.1 NQF QDM 4.1.1 IHE Quality Measure Execution for Early Hearing (QME-EH) Structured Data Capture (SDC) Vocabulary Standards SNOMED CT LOINC Electronic Medical Record (EMR) System Produce C-CDA R1.1 CCD Public Health Information System (PHIS) Consume CCD Produce QRDA Cat I and Cat III Consume QRDA Cat I and Cat III

9. Discussion What level of effort do you foresee in developing this profile? -Moderate Effort -Content Profile – -Primarily an update of standards -QRDA Document vs. CDA Document content modules -US and International solution simultaneously addressed (?) -New Use Case work -New Actor-Transaction Diagram -No new actors, no new transactions -Grouping of existing IHE Actors -(Content Creator, Content Consumer grouped with other IHE Actors) - New Sequence Diagram Profile Editor: Lisa Nelson, Lantana Consulting Group Lisa.Nelson@LantanaGroup.com