1. PHDSC Meeting, MD, Nov. 8-9, 2012 Standards Development in support of Public Health EHDI Program Lisa R. Nelson, MS, MBA Public Health Data Standards Consortium lisarnelson@cox.net 1

2. What is Early Hearing Detection and Intervention?

3. Why is Newborn Hearing Screening Important? Associated with increases in educational cost  Incremental special education cost of $115,600 * per child in US  EHDI reduction in educational costs of $44,200 * or $200 million each year One of the core newborn conditions on the Recommended Uniform Screening Panel Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC), US Dept. of Health and Human Services U.S. Preventive Services Task Force (USPSTF) recommends screening for hearing loss in all newborn infants (Grade B - July 2008) EHDI Quality Measures included in Meaningful Use Stage 2 High incidence of Hearing Loss among screened conditions for newborns Negative impacts on a child’s ability to develop communication, language, social skills, and school achievement

4. Interoperability allows two or more systems to transmit, exchange, store, and manage information electronically Nationally recognized health IT standards provide the base for the flow of information securely, reliably, consistently, and accurately National Health IT Standards enable Interoperability How do we make this possible?

5. US Initiatives International Initiatives US HIT Policy Committee & US HIT Standards Committee What standards efforts can be leveraged? Dept.of Health and Human Services, Office of National Coordinator for Health IT (ONC), Standards & Interoperability Framework

6. Overview of PHDSC Standards Work HL7 CDA  Clinical Document Architecture, Release 2 HQMF  Health Quality Measure Format QRDA  Quality Reporting Document Architecture HL7 v 2.x  Admission message  Observation Result message HL7 v3  Patient Registry Tracker message IHE EHCP  Early Hearing Care Plan QME-EH  Quality Measure Execution for Early Hearing NANI  Newborn Admission Notification Information DEC  Device Enterprise Communication EHDI-WD  EHDI Workflow Document 6

7. How do these efforts relate? HL7 CDA  Clinical Document Architecture, Release 2 HQMF  Health Quality Measure Format QRDA  Quality Reporting Document Architecture HL7 v2.x  Admission message  Observation result message HL7 v3  Patient Registry Tracker message IHE EHCP  Early Hearing Care Plan QME-EH  Quality Measure Execution for Early Hearing NANI  Newborn Admission Notification Information DEC  Device Enterprise Communication EHDI-WD  EHDI Workflow Document 7

8. How do they help? HL7 CDA  Interoperable structured document HQMF  CQM defined for computer processing QRDA  Data that supports assessing a CQM or represents calculation of a CQM HL7 v 2.x  Newborn admission message  Device result message HL7 v3  Newborn notification message IHE EHCP  Interoperable early hearing care plan structured document QME-EH  Quality measure data supporting calculation of EHDI-1a CQM NANI  Standard newborn admission notification information DEC  Standard device screening results EHDI-WD  Orchestration of the EHDI workflow for patient care 8

9. Where do these standards support the EHDI program? EHCP NANI QME-EH DEC EHDI-WD