1. Public Health Reporting Initiative Stage 3 Sprint: Implementation Guide Development 1

2. Agenda Introductions Objectives Benefits Proposed Report Structure Common Core Data Elements Report Type Specific Data Elements Implementation Specific Data Elements Tiers Scope Approach Proposed Ground Rules Timeline Questions

3. Introductions Workgroup Lead: Seth Foldy User Story Representation Other Membership Support Team Reportable Conditions HAI Cancer Registry Early Hearing Adverse Event (Drug, Medical, Vaccine, Biologic) Vital Statistics – Birth & Fetal Death National Hospital Care Survey Immunization Registry Tobacco Quit Lines Cancer Genetics

4. Stage 3 Sprint Objective Develop a harmonized implementation specification for public health reporting that can be tested and implemented in time for MU Stage 3 –Testing by late fall-early winter 2012 –Implementation by Oct 2015 Compatible with needs of multiple report types across multiple public health domains –Specification can serve multiple report types through shared “core” data elements –Also includes harmonized data elements for specific report types

5. Benefit of the Stage 3 Sprint The Stage 3 Sprint will produce a harmonized specification for consideration for Stage 3 MU incentives & EHR certification –Full specification of some report types ready to have pilot-tested specification by winter 2012/national implementation by 2015 Defined as “Tier 1” for the Stage 3 Sprint –Produce compatible, reusable elements for those less likely to be ready in 2015 Defined as “Tier 2” for the Stage 3 Sprint –Serves multiple reporting programs Development of a set of common core data elements and a consensus on format to streamline reporting programs and enable interoperability

6. Public Health Report Structure Implementation specific data elements Report-type specific data elements Common core data elements Specific to local or program- specific data needs Desire that these be minimized For a “type of report”: e.g. TB Harmonized when possible Reused as appropriate Harmonized Elements reused by many report-types across several domains Public Health Report = Common Core Data Elements + Report-type Specific Data Elements + Implementation Specific Data Elements

7. Tiers of Report Type Participation In order to achieve the goal for a pilot-tested implementation specification by winter 2012, user stories for particular report types were assessed for “readiness” and classified into tiers Entire group participates in the development of the common core set of data elements Group also develop Tier 1 report-type specific elements for first release of the PHRI Implementation Guide Tier 2 may develop report type specific elements for subsequent releases Seek full consensus on implementation guidance, but if Tier 2 issues impede consensus may place their issues in “parking lot” for future releases

8. The PHRI Implementation Specification Release 1 Core Specification –Common core Data Elements –Exchange format(s) selected by Sprint group Tier 1 Report-Type Specifications, potentially including: –Reportable condition case reports (communicable and environmental) –HAI reports –Cancer Registry reports –Early Hearing Detection reports –Birth and Fetal Death report –Adverse Event reports (drug, device, biologic) PHRI Implementation Specification 8

9. PHRI Implementation Specification Development Approach Select core set of data elements/terminologies/value sets as foundation for many public health report types Align to PHRI Data Harmonization Profile for both common core data elements & report-type specific data elements Analyze and select format standard(s) –Choose standard based on use cases, functional requirements, and capacity to adopt Standards Harmonization –For implementation of both common core selected report-type specific data elements –To accomplish use case and functional requirements –To support more uniform public health reporting infrastructure: sending + receiving 9

10. Establish Set of Common Core Data Elements Set of common core data elements used widely across different public health reporting domains and report types –Aligned to the Data Harmonization Profile –Intended to serve a wide variety of report types These common core data elements will be mapped into S&I Clinical Element Data Dictionary (CEDD) and other tools to achieve –Reusable collection of public health data elements for Electronic Health Records –Guide coding of public health data elements in EHR –Identification of areas of need for standards development

11. Format Standards Analysis Depending on use case/functional requirement needs and adoption-readiness, specification based on either or both of: –HL7 v2.x messaging –HL7 CDA (likely “consolidated CDA”) documents Key Considerations –Modularity –Extensibility –Capability of EHR and PH systems to adopt Gaps identified during the analysis will be addressed through standards harmonization

12. Standards Harmonization The harmonization process seeks to align standards in order to meet the functional and business requirements of public health domains The harmonized core specification needs to take all Tier 1 and as many Tier 2 requirements into consideration as possible –The resulting harmonized core specification will level the playing field to increase HIT adoption and electronic information exchange capabilities across all public health domains The harmonization process: –Builds a consistent representation of required information –Addresses gaps in standards & specifications –Enhances currently-employed standards & specifications –Establishes a uniform specification with broader applicability

13. 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

14. Week12 3456789 PHR IG Release 1 Meeting Date (Thursday 2-4 PM EST) 7/197/268/28/98/168/238/309/69/13 Activity Establish common core Set of Data Elements Alignment to PHRI Data Harmonization Profile Analysis of Standards for a Public Health Report Analysis of Standards for Included Report Type Extensions Standards Harmonization Implementation Specification Development (Support Team) Additional Activities Ballot (TBD) Consensus Stage 3 Sprint- Activity Timeline Kick-off Meeting

15. Next Steps / Questions Work Group Meeting PHRI Stage 3 IG Development: Thursdays 2 – 4 PM EST 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 Homework Expect an email later this week including a proposed set of common core data elements Review and come prepared to our next meeting as we move towards consensus on this set (note: questions/comments highly encouraged through email prior to our next meeting) For questions, contact Lindsay Brown (lrbrown@cdc.gov)lrbrown@cdc.gov 15