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

2. 1 PUBLIC HEALTH DATA STANDARDS CONSORTIUM ~ 2006 BUSINESS MEETING OF MEMBERS ~ March 27, 2006, Hyattsville, MD PHDSC Activities Report Anna O. Orlova, PhD Executive Director

3. 2 u Membership u Revenues u Projects and Products PHDSC Activities Report: Outline

4. 3 Membership PHDSC Activities Report

5. 4 Our Members u Federal Agencies Agencies for Healthcare Research and Quality (AHRQ) Centers for Disease Control and Prevention (CDC) CDC/ National Center for Health Statistics (NCHS) National Library of Medicine (NLM) Substance Abuse and Mental Health Services Administration (SAMSHA)

6. 5 Our Members u State and Local Agencies California Office of Stateside Health Planning and Development Massachusetts Division of Health Care Finance and Policy Minnesota Department of Health Nebraska Health and Human Services System New York City Department of Health and Mental Hygiene Ohio State Department of Health Wisconsin Department of Health and Family Services

7. 6 Our Members u Professional Membership Organization American Immunization Registry Association (AIRA) Association of Public Health Laboratories (APHL) Council of State and territorial Epidemiologists (CSTE) eHealth Initiative National Association for Health Data Organization (NAHDO) National Association of City and County Health Officers (NACCHO) North American Association of Cancer Registries (NAACCR)

8. 7 Our Members u Other Professional Organizations Delta Dental Plans Association Illinois Hospital Association Massachusetts Health Data Consortium Midwest Center for HIPAA Education Public Health Informatics Institute

9. 8 Our Members u Academic Institutions Johns Hopkins Bloomberg School of Public Health University of Connecticut Vanderbilt University

10. 9 Our Members u Supporting Members Electronic Intellect, LLC Environmental Systems Research Institute (ESRI) Fox Systems HLN Consulting, LLC IBM INSERM (France) Oracle Corporation Oz Systems Scientific Technologies Corporation (STC)

11. 10 PHSDC Membership Structure - 2006

12. 11 PHDSC Membership Structure: 2004-2006 2004 2005 2006

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15. 14 Revenues PHDSC Activities Report

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17. 16 Projects and Products PHDSC Activities Report

18. 17 PHDSC Executive Committee Retreat, October 2005, identified the following program areas: u Privacy, Security and Data Sharing u Data Standards Health Care Services Data Reporting Guide External Causes of Injury Codes Payer Type Public Health Vocabulary SDO’s and Data Content committees( X12, HL7, NUBC, NUCC) ONC – standards harmonization contract u NHIN/RHIO u EHR Certification u Communications and Outreach These Program Areas were reflected at the new PHDSC Organizational Chart. PHDSC Projects and Products

19. 18 PHDSC - Organizational Chart Normal Font - Active Committees Italic Font - Proposed Committees TBN – to be named Sub-Committees BOARD OF DIRECTORS P R O G R A M A R E A S CERTIFICATION EXECUTIVE COMMITTEE & EXECUTIVE DIRECTOR Health Care Services Data Reporting Guide PRIVACY, SECURITY & DATA SHARING External Cause of Injury Codes COMMUNICATION & OUTREACH Public Health Vocabulary Co-Chairs: Vicki Hohner & Richard Urbano Co-Chairs: David Ross & Anna Orlova Co-Chairs: Arturo Coto & Starla Ledbetter Co-Chairs: Vivian Auld & Michelle Williamson Co-Chairs: Robert Davis & Starla Ledbetter Chair: TBN Payer Typology Co-Chairs: Amy Bernstein & Judy Parlato BUSINESS PLAN DATA STANDARDSNATIONAL HEALTH INFORMATION NETWORK Chair: Robert Davis Co-Chairs: Lawrence Hanrahan & Martin LaVenture Co-Chairs: Noam Arzt & Farzard Mostashari Web-Based Resource Center Co-Chairs: Sally Klein & Michelle Williamson Task Force on Standard Harmonization Contract Task Force on Privacy Contract

20. 19 PHDSC activities conducted by the Program Committees will be presented by the Chairs in the session that follows. In summary… PHDSC Projects and Products

21. 20 PHDSC Products: 1999-04 1999 PHDSC Established as a Voluntary Confederation 2000 PHDSC Members Join Data Content Committees 06/00 Mother’s Medical Record Number is added on Health Care Claim 07/03 PHDSC became a non-profit organization 03/04 Electronic Health Record- Public Health (EHR-PH) White Paper 10/02 Health Care Services Reporting Guide 03/02 Health Data Standards Survey 05/03 Web- based Resource Center 05/01 PHDSC Education Strategy on Data Standards

22. 21 PHDSC Products: 2005-06 09/05 Privacy & Security Websites 07/05 Role of Public Health in Adoption & Use of HIT 02/05 EHR-PH Prototype 02/06 Towards a Payer Typology Standard 01/05 Response to the PFI on the NHIN Development & Adaptation of aNHIN

23. 22 PHDSC Grant and Contract Projects: u Small Conference Program Grant # 1R13 HS016073-01 from the Agency for Healthcare Research and Quality u Contract from Health Resources and Services Administration. Requisition/Purchase Request No.: 05- S250-0380 PHDSC Projects and Products

24. 23 PHDSC Projects and Products The Role of Public Health in the Adoption and Use of Health Information Technology Small Conference Program Grant # 1R13 HS016073-01 from the Agency for Healthcare Research and Quality Role of Public Health in Adoption & Use of Health Information Technology. Report. July 2005. URL: http://phdatastandards.orghttp://phdatastandards.org

25. 24 PHDSC Projects and Products Developing a Vision for Functional Specification Requirements for Electronic Data Exchange between Clinical and Public Health Settings: Examples of School Health and Syndromic Surveillance in New York City Contract from Health Resources and Services Administration Requisition/Purchase Request No.: 05-S250-0380

26. 25 PHDSC Project on a Vision for EHR-PH Functional Specifications Standard (HRSA) Project Rationale: To help facilitate the development of interoperable EHR- Public Health (EHR-PH) system there is a need to describe work processes that support data exchange between clinicians and public health practitioners to formulate functional requirements for electronic communication between clinical and public health settings, so that the EHR- PH data/information exchange deployed at one clinical setting to transmit data to a public health agency can be replicated at other clinical facilities.

27. 26 PHDSC Project on a Vision for EHR-PH Functional Specifications (HRSA) Project Summary: Collaboration with New York City’s Department of Health and Mental Hygiene (DOHMH) - our member. Two DOHMH Public Health Programs are included: School Health Syndromic Surveillance Clinical setting – NYC Community Health Center equipped with the EHR system. Draft report was submitted to HRSA for review on 2/19/06.

28. 27 PHDSC Project on a Vision for EHR-PH Functional Specifications (HRSA) Functional specifications were developed in the format of the Requirement Analysis Document (RAD) that documented data exchange processes and include the description of: Goals of the EHR-PH Data Exchange Functions that the EHR-PH Data Exchange will support Actors – stakeholders – participant in data exchange Actions – stakeholders activities Data Sources – public health reporting forms Dataflow and Workflow Models Proposed System Architecture

29. 28 School Health: Current Work Flow and Data Flow Model CHC EHRS Reports Child with parent visits provider Provider completes 211S Parent deliver 211S to school Patient Record School DB School nurse enter 211S data into ASHR ASHR 211S Form DOHMH maintains ASHR 211S Form 211S Form 211S Form EHR

30. 29 CHC-I EHRS EHR Community Health Centers (CHC) New York City Department of Health & Mental Hygiene Automated Student Health Record (ASHR) System School Forms School-II System School Forms School-N System School Forms School-I System School Forms New York City Schools CHC-II EHRS EHR CHC-N EHRS EHR 211S Form RES Form MUM Form Consent Form School Health: EHR-PH Data Exchange

31. 30 Laboratory Ambulatory Care Pharmacy Response Team State Public Health Surveillance System Syndromic Surveillance: Workflow and Dataflow DHHS 1- Report/retrieve of symptoms, diagnosis & medication prescription data from EMRs 2 – Data mining of EMR notes 3 – Notify on increased number of cases & recommend to order pathogen test 4 – Order pathogen test 5 – Report positive test result electronically & by phone 6 – Report on the positive case electronically & by phone Media Local Public Health Surveillance System Hospital Neighboring Jurisdictions PUBLICPUBLIC

32. 31 PHDSC Project on a Vision for EHR-PH Functional Specifications Standards (HRSA) Proposed Recommendations: Conduct validation of the functional specifications across relevant public health agencies programs to build a consensus on the format and content of the requirements specification for the selected domains and develop a consensus-based functional specification requirements for the EHR-based data exchange in school health and syndromic surveillance. Work with interested public health agencies (local, state and federal) to develop functional specification standards for other public health programs (domains). Communicate to the health IT community the need for the development of EHR-PH functional standards and inclusion of these standards in the EHR certification process.

33. 32 Acknowledgements NYC Dept. of Health and Mental Hygiene u Dr. Farzad Mostashari, Assistant Commissioner u Dr. Oxiris Barbot, Medical Director, Bureua of Dchool Health u Dr. Neil Calman, Director, The Institute for Urban Family Health, New York City Health Resources and Services Administration (HRSA) u Ms. Jessica Townsend and Dr. Michael Millman, Office of Planning and Evaluation

34. 33 Standards Harmonization Contract, Office of National Coordinator for Health Information Technology (ONCHIT), Department of Health and Human Services; Start Date: October 19, 2006 Privacy Contract, Agency for Healthcare Research and Quality; Start Date: October 1, 2006 Presentations on these projects are scheduled on March 28 PHDSC Projects and Products