1. Laura Bright, LJB Consulting, Inc. Gila Pyke, Cognaissance, Inc.
Family Planning version 2 Brief Profile Proposal presented to the Quality, Research & Public Health (QRPH) Planning Committee
Laura Bright, LJB Consulting, Inc.
Gila Pyke, Cognaissance, Inc.
Lauren Lemieux, ACOG
Emily Decker, OPA
October 19, 2016

2. Title X Family Planning Program
WORLD
Title X Family Planning Program
Operated by HHS Office of Population Affairs since 1970
4300 clinics provide contraceptive services and related health services
Grantees report key performance data on ~5 million patients per year
Reporting is done via the Family Planning Annual Report (FPAR)

3. The Problem Assure appropriate reproductive care for all patients
Standardization of data collection around contraception, pregnancy intention is needed to improve health outcomes. Unintended pregnancies are at higher risk for poor health and social outcomes.
Reporting and Clinical Quality Measures standards are evolving
Pregnancy intention and contraceptive method are essential health indicators. The usefulness and reliability of indicators and quality measures is dependent on the existence of quality data.
The burden of data collection is increasing
Differences in data collection methods, and data definitions, means a substantial effort is required to extract meaningful data from existing systems.

4. The Problem The update of the Family Planning profile will:
Process
The Problem
The update of the Family Planning profile will:
Add flexibility to the submission pathways to ensure a suitable workflow is available for all kinds of systems.
Align CDA document types used in the profile with standard C-CDA documents used in other US initiatives.
Define the cardinality and structure of form data, as well as CDA document data, to ensure data definition and collection is consistent across all submission pathways

5. Value Proposition For Title X: Improve the accuracy of collected data
Process
Value Proposition
For Title X:
Improve the accuracy of collected data
Improve population representation
Provide more granular, visit level data
For Clinicians:
Provide interoperable approach to data collection with minimal workflow burden
Enable feedback to improve quality of care
For Clinics:
Reduce burden associated with extracting and reporting
Reduce need to customize EHR software and associated costs

6. Existing IHE Profiles and Risks
Risk of this proposal not being undertaken this cycle?
Lost of momentum started with current FPAR 2.0 project
Lose interest from sponsors at OPA and ACOG
Miss opportunity to capitalize on available funding to provide technical resources for profile development
Miss opportunity for IHE involvement in proposed pilots and implementation project

7. Use Case 1 Current Use Case
Clinic A creates dummy CPT codes for contraceptive methods, which are added to paper billing form, and entered into practice management system by billing staff
Clinic B adds custom fields to their EHR to capture the data, requiring expensive vendor fees for customization
Data format and codes are not consistent across sites. Correlation of data across sites and regions is difficult, if not impossible
Proposed Use Case
Clinic A uses an EMR that can produce a Family Planning CDA document. The clinician records the data in the EMR. At the end of the visit, the FP CDA document is submitted to the FPAR system
Clinic B queries for and displays a Family Planning form. The clinician fills out the form and submits it to the FPAR system at the end of the visit.
The FP CDA document and the FP form use the same data definitions, fields and formats, enabling consistent data collection, and correlation across all sites.

8. Proposed Standards & Identified Systems
HL7
CDA R2, C-CDA R1.1 CCD
IHE
Retrieve Form for Data Capture (RFD)
Structured Data Capture (SDC)
Vocabulary Standards
SNOMED CT
LOINC
CPT
HCPCS
Electronic Medical Record (EMR) System
Produce Family Planning CDA document
Query for Family Planning Form
Send completed Family Planning Form
Family Planning Annual Reporting System (FPAR 2.0)
Consume Family Planning CDA document
Store Form and Form data
Pre-populate Form from CCD or other CDA document types

9. Discussion
What level of effort do you foresee in developing this profile?
Moderate Effort
Content Profile
Inclusion of new fields, and new document types for pre-pop
Definition of form fields and data formats
International base profile and US extensions
New Use Cases
Addition of CDA document submission along with forms based workflow
New Actor-Transaction Diagram
No new actors, no new transactions
Addition of existing IHE Actors for CDA document submission workflow
- New Sequence Diagrams for new use cases
Profile Editors:
Laura Bright Gila Pyke Lauren Lemieux