Public Health Data Standards Consortium phdatastandards

1. Public Health Data Standards Consortium http://phdatastandards.info

2. PUBLIC HEALTH DATA STANDARDS CONSORTIUM ~ 2005 BUSINESS MEETING OF MEMBERS ~ May 24, 2005, Washington DC Report on the Consortium’s Activities Anna O. Orlova, PhD Executive Director

3. PHDSC – Membership Structure 2004 2005

4. PHDSC Activates on Electronic Health Record (EHR) Dec-March 04 PHDSC Ad Hoc Task Force on Electronic Health Record-Public Health (EHR-PH) to validate Health Level 7(HL7) EHR Functional Model July-Dec. 04 Pediatric EHR – Public Health Perspectives. Contract from HRSA Jan-Feb. 05 Demonstration of Interoperability Across Clinical and Public Health Systems via EHR, HIMSS-2005

5. PHDSC Ad Hoc Task Force on Electronic Health Record-Public Health (EHR-PH) WHITE PAPER on Electronic Health Record: Public Health Perspectives (EHR-PH) March 2004 Purpose: (1) to communicate to the public health community a need for broader involvement in the national effort to standardize clinical and public health data and information systems, and (2) to describe public health perspectives on the EHR.

6. PHDSC Project on Pediatric Electronic Health Record-Public Health (PEHR-PH) Funded by HRSA Goal is to contribute to the definition of and development of the pediatric EHR from public health perspectives (PEHR-PH). The PEHR-PH is seen as a two way clinical and public health information interchange for the purpose of providing the best health care service to children.

7. PHDSC Project on Pediatric Electronic Health Record-Public Health (PEHR-PH) Funded by HRSA

8. Cross-mapping of Clinical and Public Health Data ROUTINE VISITS OF WELL CHILD CARE; AGE 0-6mos and at 5y • 8 CLINICAL FORMS (Hospital of Birth; Outpatient Pediatric Clinic – Johns Hopkins Hospital) • 7 PUBLIC HEALTH FORMS (State Health Department – Maryland State Department of Health and Mental Hygiene) • 1st Newborn Metabolic Screening • Hearing Screening • Immunization • Birth Defect Form • Vital Registration • 2nd Newborn Metabolic Screening • Child Health Inventory (5 years of age)

9. Cross-mapping of Clinical and Public Health Pediatric Data • Clinical system is a significant source of data for pediatric public health systems • 59% data concepts used in clinical care maps to public health data needs • Significant redundancy can be overcome if EHR systems will populate public health programs

10. Current Workflow for Data Interchange between Primary Care and Public Health Health Care Provider Public Health Agency Patient Hearing Registry Create the form Receive the form Newborn Screening Registry Verify data on the form Patient Record Enter data to PH DB Create the form Verify data entry Create the form Receive the form Manage data in PH DB Record data on the form Verify data on the form Analyze data Verify data on the form Enter data to PH DB Generate reports Enter data to PH DB Verify data entry Verify data entry Manage data in PH DB Manage data in HCP DB Communicable Disease Registry Analyze data Generate reports Generate reports Create the form Receive the form Verify data on the form Immunization Registry Enter data to PH DB Create the form Verify data entry Receive the form Manage data in PH DB Verify data on the form Analyze data Enter data to PH DB - Actions related to services Generate reports Verify data entry - Actions related to data management Manage data in PH DB Analyze data Generate reports

11. EHR-based Workflow for Data Interchange between Primary Care and Public Health Health Care Provider Public Health Agency Patient Hearing Registry Create the form Retrieve Data from EHR DB Analyze data EHR System Newborn Screening Registry Generate reports Create the form Record data on the form Create the form Verify data on the form Retrieve Data from EHR DB Communicable Disease Registry Enter data to HCP DB Analyze data Verify data entry Generate reports Create the form Manage data in HCP DB Retrieve Data from EHR DB Analyze data Generate reports Immunization Registry Generate reports Create the form Retrieve Data from EHR DB - Actions related to services Analyze data Generate reports - Actions related to data management

12. Public Health Vision for Interoperability across Different Systems: Building EHR-PH System Prototype Clinical Care Patient Public Health Personal Health Record Newborn Screening Registry Health Care Provider 1 Newborn Screening Program EHR-PH DATA EXCHANGE Health Care Provider 2 Hearing Screening Registry Hearing Screening Program Immunization Program Health Care Provider 3 Immunization Registry Communicable Disease Reporting Program Communicable Disease Registry Laboratory

13. PHDSC EHR-PH System Prototype for Interoperability of Clinical and Public Health Systems, HIMSS-2005 Clinical Care Public Health Hospital of Birth State Health Department ADT- Birth Record Newborn Screening Registry HL7 2.4 HL7 3.0 EHR-PH Info Exchange Newborn Screening Test HL7 3.0 HL7 3.0 Hearing Screening Registry HL7 3.0 HL7 2.4 Hearing Screening Test HL7 2.4 Immunization Registry J2EE HL7 2.4 Immunization Administration Communicable Disease Registry External Laboratory Source: Orlova, et al. HIMSS 2005,Dallas TX, February 13-17, 2005

14. EHR-PH System Prototype for Interoperability in 21st Century Health Care System Our Prototype • illustrates how interoperability between healthcare systems can be achieved with a standards-based infrastructure • Is built upon existing systems in clinical care and public health programs • Enables electronic data reporting from a clinical setting to multiple public health systems • Enables translation of customized standards into HL7 3.0 messaging standard • Links clinical and public health systems to provide a continues view of the patient record across the systems involved

15. EHR-PH Demonstration: Partners DESIGN ¤ NEWBORN SCREENING ¤ HEARING SCREENING DEPLOYMENT ¤IMMUNIZATION ¤COMMUNICABLE DISEASE REPORTING Slide 14 Slide 14

16. EHR-PH Demonstration: Design Development • Laboratory • NEDSS Comparability CDC Slide 15

17. Acknowledgements • Dr. David Ross, Director, Public Health Informatics Institute Health Resources and Services Administration (HRSA) • Ms.Jessica Townsend and Dr. Michael Millman, Office of Planning and Evaluation & • Dr. Marie Mann, Genetic Services Branch, Maternal and Child Health Bureau Technical Panel • Dr. David Hollar, University of Tennessee Graduate School of Medicine • Dr. Harold Lehmann, Dept. of Pediatrics, Johns Hopkins Medical Institutions • Dr. Christoph Lehmann, Dept. of Neonatology, Johns Hopkins Medical Institutions • Dr. Susan Panny, Director, Office of Genetics and Children with Special Needs, Maryland State Department of Health and Mental Hygiene • Dr. Phillip Gioia, President, Children Health Specialists, Inc., and Cayuga County Health Department • Dr. Paul Biondich, Regenstrief Institute, Inc. and Department of Children’s Health Services

18. Acknowledgements EHR-PH Demonstration • Ms. Michelle Williamson, National Center for Health Statistics • Dr. Michael Higgins and Mark Dunnagan, Oracle • Dr. Allen Tien and Steven Beales, Medical Decision Logic, Inc. • Drs. Terese Finitzo and Ken Pool, OZ Systems • Mr. Todd Watkins, Science Technologies Corporation Special Thanks to • Dr. Steven Steindel, Centers for Disease Control and Prevention • Dr. Eillen Koski, QuestDiagnostics, Inc.

19. PHDSC Committee on a National Health Information Network RESPONSE TO THE REQUEST FOR INFORMATION on the Development and Adoption of a National Health Information Network from the Office of National Coordinator for Health Information Technology (ONCHIT), Department of Health and Human Services; Released on November 15, 2004 Submitted to ONCHIT on January 18, 2005