Transcript Slide 1

Public Health Data Standards Consortium
http://www.phdsc.org
PUBLIC HEALTH DATA STANDARDS CONSORTIUM
~ 2007 BUSINESS MEETING OF MEMBERS ~
October 2-3, 2007, Hyattsville, MD
PHDSC
Nationwide Health Information Network
Committee Activities
PHDSC NHIN Committee
Purpose:
 To foster awareness, partnerships and
collaboration at the local, state and
national levels in the development of the
regional health information exchanges.
PHDSC NHIN Committee
The Nationwide Health Information
Network (NHIN) is a health information
technology strategy that will provide the
foundation for an interoperable, standardsbased network for the secure exchange of
health care information.
US Health Information Network - 2014
Source: Dr. Peter Elkin, Mayo Clinic, MN
DHHS’ Framework for Health Information
Technology: Building a NHIN
NHIN will be based on:
Electronic
Health Record Systems (EHRS) that
will enable
Regional Health Information Exchanges (RHIEs)
Thompson TG and Brailer DJ. The Decade of Heath Information Technology to Deliver Consumer-centric
and Information-rich Health Care. Framework for Strategic Action. US DHHS, July 21, 2004.
Source: Dr. Peter Elkin, Mayo Clinic, MN, 2006
RHIEs as NHIN Components
Health IT Standards
In February 2006 the Health Information
Technology Standards Panel (HITSP)
developed the classification of health
information technology standards
HITSP URL:http://www.ansi.org/standards_activities/standards_boards_panels/hisb/hitsp.aspx?menuid=3
HITSP Standards Categories
1.
2.
3.
4.
5.
6.
7.
Data Standards (vocabularies and terminologies)
Information Content Standards (Reference
Information Models (RIMs))
Information Exchange Standards, e.g.,
messaging standards
Identifiers Standards, e.g. National Provider
Identifier (NPI))
Privacy and Security Standards
Functional Standards, e.g. processes/workflow
Other, e.g. IT standards
HITSP Standards Categories – New Stds Types
1.
2.
3.
4.
5.
6.
7.
Data Standards (vocabularies and terminologies)
Information Context Standards (Reference
Information Models (RIMs))
Information Exchange Standards, e.g.
messaging standards
Identifiers Standards, e.g. National Provider
Identifier (NPI))
Privacy and Security Standards
Functional Standards, e.g. processes/workflow
Other, e.g. IT standards
HITSP Standards Categories
To date, the main focus of standard
development activities has been on
data standards
information context standards
messaging standards and
infrastructure standards
National Biosurveillance Use Case
Transmit essential ambulatory care and
emergency department visit, resource utilization,
and lab result data from electronically enabled
health care delivery and public health systems in
standardized and anonymized format to
authorized Public Health Agencies with less than
one day lag time.
HITSP URL: www.hitsp.org
National Biosurveillance Use Case
HITSP Interoperability Specification, 2006:
Number of standards by category:
(1) Terminology 28
(2) Context Information Model 17
(3) Information Exchange 46
(4) Identifier (Individual and Organization) 5
(5) Privacy and Security 11
(6) Functionality and Process (Workflow) 0
(7) Other 0
Biosurveillance Use
Case Workflow
Neighboring
Jurisdictions
EHRS
Hospital State Public Health
Surveillance System
1- Report/retrieve symptoms, diagnosis &
medication prescription data from EMRs
Ambulatory
Care
4 – Order
pathogen
test
2 – Data mining
of EMR notes
3 – Notify on
increased number
of cases &
recommend to
order pathogen test
5 – Report
test results
7 – Report on the positive case
electronically & by phone
Public Health
Biosurveillance
System
DHHS
6 – Report
positive
test result
electronically
& by phone
Media
Laboratory
Pharmacy
Response
Team
P
U
B
L
I
C
Functional Standards
To date, there is no consensus on the format,
content, and approach for how to specify
functional standards.
2005 PHDSC-HRSA Project
Developing a Vision for Functional Standard for
Electronic Data Exchange Between Clinical and
Public Health Settings – NYC Examples:
 Examples of School Health
 Syndromic Surveillance
Contract # 05-S250-0380 from
Health Resources and Services Administration
2005 PHDSC-HRSA Project
Study Methodology:
 Requirement Elicitation: interviews with
clinicians and public health practitioners on
the work processes and data exchanges
Study Outcome:
 Functional Requirement Analysis Documents
(FRADs) for NYC School Health and
Syndromic Surveillance Programs
Functional Requirements Analysis Document (FRAD):
Outline
1. Introduction (Problem Overview)
1.1 Purpose of the Proposed System
1.2 Actors and Scope of the Proposed System
1.3 Objectives and Success Criteria of the Project
2. System Requirements
2.1 Functional requirements
2.3 Non-functional requirements
3. System Models
3.1 Use Case Description
3.2 Use Case Models
3.2.1 Use Case Diagram
3.2.2 Work Flow and Data Flow Model
3.3 High-Level System Architecture
4. Project Development Timeline
5. Testing / Evaluation Plan
2006 PHDSC-HRSA Project
PHDSC/HRSA EXPERT PANEL
IN ELECTRONIC DATA EXCHANGES
December 5-6, 2006,
Washington DC
Contract # HHSH250200616198P from
Health Resources and Services Administration
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
Goal
The goal of the Panel is to build consensus
among leaders in public health and clinical
electronic health information exchanges
towards formalizing a vision for a standard
representation of public health work
processes for the electronic health
information exchanges with clinical care, i.e.
functional standard.
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
HRSA Project Officers:
Ms. Jessica Townsend
Dr. Michael Millman
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
PANELISTS:
Dr. Oxiris Barbot, NYC Department of Health and Mental Hygiene, NY
Dr. Neil Calman, Institute for Urban Family Health, NYC, NY
Ms. Kathleen Cook, Lincoln-Lancaster County Health Deptment (City of
Lincoln, County of Lancaster), NE
Dr. Art Davisson, Denver Public Health, CO
Dr. Peter Elkin, Mayo Clinic, Rochester, MN
Dr. Martin LaVenture, Minnesota Health Department, MN
Dr. David Lawton, Nebraska Health and Human Services System, NE
Dr. Farzad Mostashari, NYC Dept. of Health & Mental Hygiene, NYC
Dr. Anna Orlova, Public Health Data Standards Consortium
Dr. David Ross, Public Health Informatics Institute
Dr. Tom Savel, Centers for Disease Control & Preventions (CDC)
Dr. Walter Suarez, Public Health Data Standards Consortium
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
Meeting Objectives:




Share experiences in building health information exchanges
in panelists’ jurisdictions to date
Discuss national initiatives on the development of functional
standards in health information exchanges
Discuss the Functional Requirements Analysis Documents
for health information exchanges on School Health and
Syndromic Surveillance in New York City as prototypes of
functional requirements specifications, i.e., functional
standards
Develop recommendations for the roadmap on developing
functional standards on health information exchanges
between clinical care and public health
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
QUESTIONS FOR DISCUSSION

Does the NYC documents adequately describe user needs in
terms of system goal, actor, function, workflow and dataflow?

Does it include necessary elements needed to build the user
requirements? What is missing?

Is it reusable for other public health
domains/programs/jurisdictions?

What is the right name for this document – Functional
Requirements Specification? Use Case Description?
Functional Standard? Functional Requirement Analysis
Document (FRAD)? Other?
PHDSC / HRSA EXPERT PANEL IN ELECTRONIC DATA
EXCHANGES
Recommendations
 Use
the NYC Functional Requirement Analysis Documents
(FRADs) for School Health and Syndromic Surveillance as
working documents towards the development of the functional
standard document
 Expand
the NYC specifications by describing other public health
domains/programs in the FRAD format to facilitate the
development of the software applications in the EHR systems to
transmit/report/exchange data across clinical and public health
information systems
 Form
public and private partnerships with clinical and vendor
communities to develop interoperable clinical-public health
information systems and
 Educate
public health and clinical communities about their roles
in the development of the functional standards and overall
standards development and harmonization processes.
2006 PHDSC-HRSA Project
Towards a Functional Standard on Electronic
Data Exchange between
Clinical Care and Public Health
Draft Final Report will be Presented for Committee
Review in October
Contract # HHSH250200616198P from
Health Resources and Services Administration (HRSA)
NHIN Committee Members
Co-Chairs:
Anna Orlova
David Ross
Members:
Noam Arzt
Kathleen Cook
Michael Davisson
Terese Finitzo
Marjorie Greenberg
Lawrence Hanrahan
David Hollar
Hetty Khan
Glenda Kelly
Christopher Kinabrew
Denise Love
Carol Quinsey
Robert Rej
Susan Salkowitz
Perry Smith
Steven Steindel
Walter Suarez
Walter Tsou