1. IHE QRPH Maternal and Child Health IHE Webinar Series Lori Fourquet e-HealthSign LLC

2. Maternal and Child Health Content Health at Birth Summary (HBS) content profile containing a summary of all the information impacting on the newborn’s health status evaluation as presented in the birth certificate. Child Growth Summary (CGS) content profile representing information about the child’s development (medical and social conditions) that can be submitted to health authorities for possible intervention or general epidemiological studies.

3. Maternal and Child Health Profile Value Proposition – Allow for communications of vital records through electronic EHR sources: Birth Certificate Fetal Death Certificate Health Certificate at Birth Health Certificate at Nine Months Health Certificate at Two Years – Minimize duplicate data entry – Improve efficiency and accuracy

4. US Extension Use Retrieve Form For Data Capture Provides specific mapping to US Vital Records Forms and Data Elements Provides Value sets supporting the mapping

6. IT Infrastructure Components Supporting Public Health Cross-Enterprise Document Sharing (XDS) Cross-Enterprise Document Reliable Interchange (XDR) Cross-Enterprise Document Media Interchange (XDM) Patient Identifier Cross Reference Manager (PIX) Patient Demographics Supplier (PDQ) Pediatric Demographics Option (PDO) Retrieve Form for Data Capture (RFD) Audit Record Repository (ATNA) Time Server (CT) Personnel White Pages (PWP) Cross-Enterprise User Assertion (XUA) Cross Community Access (XCA) Basic Patient Privacy Consents (BPPC) Cross-enterprise Sharing of Scanned Documents (XDS-SD) Document Digital Signature (DSG) Enhanced Sharing Value Sets (ESVS) Document Metadata Subscription (DSUB) Multi-Patient Queries (MPQ)

7. Sharing Value Sets Addresses synchronization of content terminologies across applications Key to semantic interoperability for quality, research and public health analysis. Supports communication of value set groups supporting specific functions (e.g. Value Sets associated with Vital Records data pre-population Retrieve Form for Data Capture Supports integration of form-based data capture directly within the EHR Supports communication of Routine EHR-generated HL7 CDA Structured Clinical Documents to enable pre-population of form data delivered to the user via the EHR interface XDS/XDM/XDR Supports communication of CDA document with Vital Records Content 7 MCH Infrastructure Profiles Supporting Public Health

8. Copyright IHE International 2009 8

9. 9 Vital Records Birth and Fetal Death Data Capture Form Filler Form Manager Retrieve Form [ITI-34] along with pre-population data Continuity of Care Document (CCD) Form Delivery of Form along with pre- population data bound to the form Labor & Delivery Document LDR + DE Birth/FD Message XSLT Reference Implementation Form Manager Form Receiver

10. 10 PCC Profiles Medical Summaries Emergency Department Referral Exchanging PHR Content Antepartum Care Summary Emergency Department Encounter Summary Functional Status Assessments 2005-06 2006-07 2007-08 2008-09 2009-10 IntegrationContent Query for Existing Data Antepartum Record Immunization Registry Content Care Management Request for Clinical Guidance Labor and Delivery Record Patient Plan of Care EMS Transfer of Care

11. Antepartum Record Scope Electronically share data related to antepartum care between systems found in settings such as: Ambulatory offices Specialists offices Hospitals/birthing facilities

12. Antepartum Record Profile Abstract APR is a folder of content profiles that contains the record of antepartum care including: Antepartum History and Physical Antepartum Summary Antepartum Laboratory Antepartum Education

13. Labor and Delivery Record The LDR Profile provides information to the health care providers about the labor and delivery and the newborn in an in-patient setting Useful for – Transfers of care in the in-patient setting (OR or NICU) – Post-partum outpatient care – Pre-population of Birth/Fetal Death Certificate (QRPH)

14. Copyright IHE International 2009 14 Maternal Child Health Content profile describes to automating data capture in vital records such as the birth certificate or early childhood health certificates. Pre-populate certificate with data from the EHR Submit certificate to interested organizations – Retrieve Form for Data Capture (RFD) – Uses transactions and content modules defined in other IHE profiles to provide interoperable data exchange. – Provides value sets supporting data mining of Labor and Delivery Documents for form pre-population

15. Provides Specific Rules to pre-populate US Birth and Fetal Death Certificate forms from the IHE-PCC Labor and Delivery Document Detailed value sets are provided supporting this US-specific data mapping that may be utilized for multiple national extensions Copyright IHE International 2009 15 Maternal Child Health: US National Extension

16. Copyright IHE International 2009 16 Maternal Child Health

17. MCH US National Extension: Pre-population Rules Copyright IHE International 2009 17 US Attri- bute code B ir t h FDFD Form Data Element DefinitionDerivation Rule MCH CodeValue sets APGA R5 YNApgar Score: 5 Minute A systematic measure for evaluating the physical condition of the infant at specific intervals following birth. Enter the infant’s Apgar score at 5 minutes. If (Result Type CONTAINS ValueSet (5 Min Apgar Score)), THEN “APGAR5” = (Result Value) Newborn Delivery Information 1.3.6.1.4.1.19376.1.5.3.1.1.21.2.4 Coded Results Result Type 1.3.6.1.4.1.19376.1.5.3.1.3.28 MCH HBS 5 Min Apgar Score Value Set 1.3.6.1.4.1.19376.1.7.3.1.1.13.8.12 Newborn Delivery Information 1.3.6.1.4.1.19376.1.5.3.1.1.21.2.4 Coded Results Result Value 1.3.6.1.4.1.19376.1.5.3.1.3.28 MECSYNCharacter istics of labor and delivery: Meconiu m staining Moderate or heavy meconium staining of the amniotic fluid Staining of the amniotic fluid caused by passage of fetal bowel contents during labor and/or at delivery that is more than enough to cause a greenish color change of an otherwise clear fluid. Information about the course of labor and delivery. IF (Problem Code CONTAINS ValueSet (MCH HBS Meconium staining Value Set) THEN “MECS” SHALL = “Y” LSE “N”E Labor and Delivery 1.3.6.1.4.1.19376.1.5.3.1.1.21.2. 3 Active Problems Problem Code 1.3.6.1.4.1.19376.1.5.3.1.3.6 MCH HBS Meconium staining Value Set 1.3.6.1.4.1.19376.1.7.3.1.1. 13.8.36

18. Potential Demonstration Scenario SceneDescriptionProfiles/ Constructs PCPMother is seen by OB/GYN for care during PregnancyAntepartum Record, XDS, Hospital of Birth Mother delivers child. Labor and Delivery Report is generated and used to pre-populate the Birth Certificate Request. LDR, RFD Public Health (VR) The Birth Certificate is Received by Public Health Vital Records. Form Manager is reviewed including interface with CDC hosted Value Sets supporting the pre-population. Data is sent routinely to CDC over the NHIN RFD, ESVS, LDR, NHIN Connect CDCCDC receives routine birth certificate information from all states. Statistic for US Births are conducted to monitor the health status of the population. NHIN Connect 18

19. Questions? Lori Fourquet lfourquet@ehealthsign.com