Transcript Slide 1

Use Case 16
Care Theme: Maternal & Newborn Health
Use Case: Vital Registration and Care Coordination for Newborn Hearing Screening
Primary Goal: Demonstrates information flow related to vital registration, newborn hearing screening, care coordination, and quality
measures that occur after baby is delivered. Newborn hearing screening is conducted after delivery. Results are transmitted to state
public health's Early Hearing Detection and Intervention (EHDI) information system (IS) to prepare an Early Hearing Care Plan
(EHCP). Care coordination is demonstrated by sharing EHCP with each baby's pediatrician. Demonstrates interoperability between
Birthing Facility Electronic Health Record (EHR) and State Vital Records’ IS. Pediatric quality measure as defined by CDC are
computed by quality measurement service provider.
Key Points:
• The demonstration uses multiple IHE profiles to show exchange of medical information between EHR Systems and the
development of long-term, quality health care plans based upon state /government historical information.
Meaningful Use Relevance: Improving Quality, Safety, Efficiency, and Reducing Health Disparities
IHE Profiles & Actors
Domain
IT Infrastructure (ITI)
Patient Care
Coordination (PCC)
Quality, Research
and Public Health
(QRPH)
Profile
Vendors
Actors
PIX, PIXv3
Oracle, Intersystems
PIX Manager
PDQ
Oracle, Intersystems
PDS Server
XCA
Oracle, Intersystems
Initiating Gateway, Responding Gateway, Registry
XCPD
Oracle, Intersystems
Initiating Gateway, Responding Gateway
XDS
Oracle, Intersystems
Document Registry, Document Repository
APS
GMT, Epic
Content Creator, Content Consumer
LDS
Epic
Content Creator
EHCP
CDC-OZ, GMT
Content Creator, Content Consumer
NANI
Epic, CDC-OZ, Intersystems
Epic, CDC-OZ, Genesis, Utah
DPH, Minnesota DPH
CDC-OZ, Intersystems
Subscriber, Manager, Information Source
BFDR
QME-EH
Form Filler, Form Manager, Form Receiver
Content Creator, Content Consumer
Care Theme: Maternal & Newborn Health
Use Case 16: Vital Registration and Care Coordination for Newborn Hearing Screening
Clinical Workflow:
HIE1| HIE2
1. OB/GYN
Collect prenatal
care info
2. Labor & Delivery
Collect birth/postpartum info
HIE2| HIE1
3. Public Health
Reporting
4. Public Health Entity
Hearing Screening
Received & Evaluated
5. Pediatrician
Retrieves EHCP
and NDS
6. HIE
Computes
eMeasures
1. OB/GYN or certified nurse/midwife (CNMW) collects mother’s demographic information and medical history during
prenatal care and provides antepartum summary, antepartum history and physical (AP*) documents which will be
available to the labor and delivery department when the mother gives birth.
2 Expectant mother arrives at Birthing Facility where, following delivery, her clinical details from birth and initial postpartum period are captured on Labor and Delivery Summary (LDS) in Birthing Facility EHR. Newborn Admission
Notification Information (NANI) on each newborn is sent to EHDI IS as a timely denominator of hospital births. Relevant
health information from LDS is sent to pre-populate the Birth and Fetal Death Report (BFDR) electronic form. Clinician
reviews and edits information in pre-populated electronic BFDR for completeness and accuracy. Upon approval, the
information from the Form populates the state/jurisdiction’s Electronic Birth Registration System. NANI sends each
Newborn’s demographics to EHDI IS.
7. CDC/NCHS
Receives info; collects
statistics for research
3. Birthing Facility EHR sends clinical data to State Public Health to pre-populate electronic Vital Records Facility
Worksheet. Completed information is transmitted to the appropriate jurisdictional authority for birth registration and
production and dissemination of local and national birth statistics.
4. Hearing screening results from Patient Care Device (PCD01) capture and/or Birthing Facility’s EHR are transmitted to EHDI Program
responsible for creating an Early Hearing Care Plan (EHCP). EHCP generated from EHDI-IS communicates newborn’s hearing screening
outcome and jurisdiction-specific guidelines for follow-up care to Pediatrician EHR through HIE. Quality Measure Execution information (QMEEH) uses NANI and EHCP available in EHDI IS to send to the HIE analytics to measure and monitor Meaningful Use Measure: NQF 1354:
EHDI-1a—Hearing Screening prior to Hospital Discharge).
5. Pediatrician receives and reviews Early Hearing Care Plan prior to well-child visit
6. Number of births (denominator) using NANI and the outcome of newborn hearing screening (numerator), are used to compute the
percentage of babies receiving screening prior to Hospital Discharge - Meaningful Use eMeasures via HIE Analytic value added services.
7. CDC/NCHS receives birth certificate information from all vital records jurisdictions. Statistics are collected and analyzed to monitor the
demographic and health status of the population and for epidemiologic research.
Visit the IHE Product Registry at: ihe.net/registry