1. Public Health Reporting Initiative Stage 3 Sprint: Implementation Guide Development Phone: 800-857-9362 x93830 1

2. Agenda New Member Introductions Implementation Guide Development: Project Plan Implementation Guide Table of Contents Next Steps Additional Questions?

3. Suggested Ground Rules Everyone may speak ID your name & user story (report type) Listen carefully Read assigned work and minutes before each meeting Limit “back-pedalling” to critical issues Yield when it is “good enough”- do not let perfection threaten good Seek consensus quickly; let moderator test consensus If consensus fails, Tier 2 steps back to see if consensus can procede for this first version of the specification Concerns about process? Immediately bring to Foldy’s attention –678-733-4289 –skf6@cdc.govskf6@cdc.gov

4. Implementation Guide Development Goal: Develop implementation guidance for the common core data elements using both 2.x and CDA in parallel Sequential approach to finalizing common core data elements and reviewing implementation guidance ToC and process: 8/30 meeting 1 st set of data elements: 9/6 meeting 2 nd set of data elements: 9/13 meeting 3 rd set of data elements: 9/20 meeting Outstanding issues & finalization: 9/27 meeting Final draft review: 10/4 meeting Data Harmonization Finalize common core objects (e.g., “Patient Information”) and associated elements Technical Team Create implementation guidance in 2.x and CDA for finalized objects Develop introductory and explanatory sections of the Implementation Guide(s) Sprint Team Review and comment on the implementation guidance Accept the final Implementation Guide(s)

5. Implementation Guide ToC Developed two preliminary tables of content to outline what is included in a 2.x guide and what is included in a CDA guide As the implementation guidance is written and reviewed, the table of contents may change to accommodate discussions/requirements out of the sprint group The Public Health Reporting Implementation guide will draw from existing implementation guidance for public health reporting (e.g., Cancer, Immunization, etc.)

6. ToC-CDA 1.Introduction6 1.1.Purpose6 1.2.Audience6 1.2.1.Requisite Knowledge6 1.3.Scope6 1.4.Summary of Key Technical Decisions6 1.4.1.PHRI User Story Development6 1.4.2.Data Harmonization Profile - Approach to Core Common and Extended6 1.4.3.Use of CDA Document Standards6 1.4.4.Conformance to this Guide6 1.5.Sequence Diagram7 1.6.Actors and Roles7 1.7.Key Technical Decisions7 1.7.1.Data Harmonization Profile Overview7 1.7.2.Exchange Specification7 1.7.3.Conformance to this Guide7 1.8.Organization of this Guide7 1.8.1.Conventions Used in this Implementation Guide7 1.8.2.Element Attributes7 1.8.3.Key Words8 2.Document Specifications8 2.1.Header8 3.Section Specifications8 3.1.Allergy8 3.2.Diagnosis8 3.3.Employer Information8 3.4.Encounter8 3.5.Facility8 3.6.Immunization (Vaccination)8 3.7.Medication8 3.8.Order8 3.9.Patient Contact Information9 3.10.Patient Information9 3.11.Procedure9 3.12.Provider Information9 3.13.Report9 3.14.Result9 3.15.Social History9 3.16.Specimen9 3.17.Vital Sign Indicators9 4.Field Level Implementation Specification9 5.Additional Implementation Guidance9 Appendix A: Reference Documents10 Appendix B: Definitions and Acronyms11 Appendix C: Summary of Data Element Optionality12 5.1.Data Element Optionality12 5.1.1.Examples of NULL Flavors12 5.2.Entity Optionality12 Appendix D: Recommended Value Sets and Vocabulary Summary13

7. ToC 2x 1.Introduction6 1.1.Purpose6 1.2.Audience6 1.2.1.Requisite Knowledge7 1.3.Scope7 1.4.Summary of Key Technical Decisions7 1.4.1.PHRI User Story Development7 1.4.2.Data Harmonization Profile - Approach to Core Common and Extended7 1.4.3.Use of HL7 2.x Messaging Standards7 1.4.4.Conformance to this Guide7 1.5.Organization of this Guide7 1.5.1.Conventions Used in this Implementation Guide7 1.5.2.Key Words8 2.Public Health Reporting Specification – HL7 Segments8 2.1.Adverse Event9 2.2.Allergy9 2.3.Diagnosis9 2.4.Employer Information9 2.5.Encounter9 2.6.Facility9 2.7.Family History9 2.8.Immunization9 2.9.Medication10 2.10.Order10 2.11.Patient Contact Information10 2.12.Patient Information10 2.13.Procedure10 2.14.Provider Information10 2.15.Result10 2.16.Social History10 2.17.Specimen10 2.18.Vital Sign Indicators10 3.Public Health Reporting Specification – HL7 Data Fields10 4.Defining the HL7 MSH Segment11 5.Public Health Reporting Specifications – HL7 2.x Messaging 11 5.1.Example – Public Health Core Report11 6.Public Health Reporting Development Resources12 7.Additional Implementation Guidance12 Appendix A: Reference Documents13 Appendix B: Requirements Traceability Matrix13 Appendix B: Definitions and Acronyms14 Appendix C: Summary of Data Element Conformance15 7.1.Optionality15 7.1.1.Examples of NULL Flavors15 Appendix D: Recommended Value Sets and Vocabulary Summary 16 8.IG Compliance Matrix – Internal Only16

8. Example Purpose (2.x guide) The purpose and value of this implementation guide document for the PHRI initiative. In the purpose section, it will be important to note why we are taking the technical approach that was taken in PHRI in relation to defining the core common, and why we will be creating implementation guides for both CDA and HL7 2.x messaging. The Public Health Reporting Specification – HL7 2.x Messaging is designed to provide a catalog of segments to be used in generating public health reports, as a series of messaging profiles for use by public health stakeholders. This approach supports multiple objectives: 1.Maintenance: Any subsequent change to any segments or fields that are used in public health reports will be made in a single source which then gets republished and made available to the public health community 2.Translation: This specification can the natural home for mapping tables from key public health reporting data elements (the core common) - the mapping tables would be built into the structure of the message 3.Familiarity: those familiar with either this guide or the CDA guide can, by contact, become familiar with the other, lessening the stress of decisions on which way to go. 4.Issues of incompatibility can be addressed in one location, so that all public health reports using HL7 2.x messaging standards can draw from a single source of changes

9. Questions to Consider As you review sections of the Implementation Guide, keep in mind: “Does the implementation format chosen make sense? I.e. When we describe what a procedures section will look like in a public health report, is it usable to an implementer?” As we move towards elaborating report type specifications, which report types can work towards 2.x and CDA guides? Leveraging the common core and then developing report type specific data elements to create implementation guidance

10. Questions / Discussion? Wiki Page http://wiki.siframework.org/PHRI+Implementation+Guide Or click “Implementation Guide” button from any PHRI wiki page Will post presentations, meeting minutes, “homework”, and documents for review Additional Questions? Contact Lindsay Brown (lrbrown@cdc.gov)lrbrown@cdc.gov 10