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Applying the Public Health Conceptual Data Model to the Implementation of the National Electronic Disease Surveillance System Abdul-Malik Shakir, Senior.

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Presentation on theme: "Applying the Public Health Conceptual Data Model to the Implementation of the National Electronic Disease Surveillance System Abdul-Malik Shakir, Senior."— Presentation transcript:

1 Applying the Public Health Conceptual Data Model to the Implementation of the National Electronic Disease Surveillance System Abdul-Malik Shakir, Senior Advisor IDX eIntelligence Solutions Group August 30, 2000

2 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 2 Presentation Overview PHCDM Project Update NEDSS Cooperative Agreement Initiatives NEDSS Development Coordination Issues IDX eSG Participation in NEDSS Identification of next steps

3 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 3 PHCDM Project Update

4 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 4 PHCDM Project Purpose The purpose of the Public Health Conceptual Data Model (PHCDM) project is to document the information needs of public health so that Centers for Disease Control and Prevention (CDC) and its state and local partners in public health can: Establish data standards for public health, including data definitions, component structures, code values, and use; Collaborate with national health informatics standards setting bodies to define standards for the exchange of information among public health agencies, and healthcare providers; Construct computerized information systems that conform to established data and data interchange standards for use in the management of data relevant to public health.

5 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 5 Overall Scope of Work Development and maintenance of the Public Health Conceptual Data Model (PHCDM) Development and maintenance of the Public Health High-level Process Model (PHHPM) Implementation of the PHCDM and PHHPM Coordination with national data-related standards Coordination with CDC Program, State, and Local public health data- related initiatives

6 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 6 PHCDM Project Goals Provide a framework for organizing public health data standards and guidelines Reduce development effort for computerized information systems for public health surveillance Enhance data exchange capabilities among public health agencies and healthcare providers Represent public health data needs to national standards setting bodies Facilitate collaboration between CDC and their state and local partners in public health.

7 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 7 PHCDM Jun-Dec 1999 Accomplishments Created a data model for public health based upon analysis of the database structures of current CDC disease surveillance systems, CIPHER data standards, the HL7 RIM, and other health related information models, and defined a maintenance process for the model. Reviewed the PHCDM with epidemiologists from within certain program areas of CDC and from state and local public health agencies and updated the PHCDM based upon their critique. Selected a computerized information system development project to make use of the PHCDM and CIPHER data standards within CDC and developed a workplan for applying the standards to the development effort. Established Jan-Jun 2000 objectives for the PHCDM project.

8 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 8 PHCDM Jan-Jun 2000 Accomplishment Published the premiere edition of the PHCDM Participated in the HL7 Reference Information Model (RIM) harmonization process to introduce public health related information needs. Began development of a public health high-level process model (PHHPM) to provide context for the PHCDM. Continued to coordinate with CDC programs and partners to endure that their information needs are represented in the PHCDM Established Jun-Dec 2000 objectives for the PHCDM project.

9 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 9 Publication of the Premiere PHCDM

10 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 10 INDIVIDUAL Birth Date : TS Death Date : TS Sex Code : CV PERSON Ethnicity Code : CV Race Code : SET Occupation Code : CV Person Name : SET NON PERSON LIVING ORGANISM Species Name : CV Organism Name : ST ORGANIZATION Organization Name : SET INFORMAL ORGANIZATION Group Type Code : CV FORMAL ORGANIZATION Industry Code : CV POSTAL LOCATION Street Address Text : AD Address Directions Text : FTX PHYSICAL LOCATION Latitude Quantity : ST Longitude Quantity : ST Location Name : ST Property Location Text : FTX TELECOMMUNICATION LOCATION Personal Identification Number : ST Time Zone Text : ST Electronic Address Text : TEL SPECIMEN Source Site Code : CV PARTY TO PARTY RELATIONSHIP Relationship Date Time Range : IVL Relationship Type Code : CV MATERIAL RELATIONSHIP Material Relationship Type Code : CV MATERIAL RESPONSIBILITY Responsibility Type Code : CV Responsibility Date Time Range : IVL Material Identifier : II Activity Relationship Code : CV LOCATION RELATIONSHIP Relationship Type Code : CV Relationship Date Time Range : IVL PARTY LOCATION PARTICIPATION Participation Date Time Range : IVL Participation Type Code : CV Current Status Code : CV Current Status Effective Date : TS MATERIAL LOCATION PARTICIPATION Participation Date Time Range : IVL PARTY Party Identifier : SET 1 0..* MATERIAL Material Identifier : SET Material Type Code : CV Material Description : FTX Material Date Time Range : IVL Handling Code : CV Danger Code : CV Material Quantity : PQ Material Name : ST 1 0..* LOCATION Location Identifier : SET Location Setting Code : CV Location Type Code : CV Location Status Code : CV Current Status Effective Date : TS Location Narrative Text : FTX 0..* * 0..1 Parties Materials Locations ACTOR PARTICIPATION Actor Type Code : CV Actor Time Range : IVL ACTIVITY RELATIONSHIP HEALTH RELATED ACTIVITY Activity Identifier : SET Activity Mood Code : CV Activity Type Code : CV Activity Descriptive Text : FTX Activity Status Code : CV Activity Date Time : GTS Activity Critical Date Time : GTS Activity Method Code : CV Subject Site Code : CV Interpretation Code : CV Confidentiality Code : CV Maximum Repetition Number : INT Priority Code : CV 0..* TARGET PARTICIPATION Target Type Code : CV Target Time Range : IVL Target Awareness Code : CV 0..* 1 1 OBSERVATION Observation Value : ANY Derivation Expression Text : ST CASE Confirmation Method Code : CV Detection Method Code : CV Transmission Mode Code : CV Disease Imported Code : CV Etiologic Status Code : CV OUTBREAK Outbreak Extent Code : CV Outbreak Peak Date : TS Outbreak Time Range : IVL INTERVENTION Intervention Reason Code Intervention Form Code : CV Intervention Route Code : CV Intervention Quantity : PQ Strength Quantity : PQ Rate Quantity : PQ REFERRAL Referral Reason Text Authorized Visit Amount Referral Description NOTIFICATION Notification Reason Code : CV Health-Related Activities

11 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 11 Mapping of the PHCDM to the HL7 RIM ORGANIZATION INFORMAL ORGANIZATION FORMAL ORGANIZATION > INDIVIDUAL NON PERSON LIVING ORGANISM > ENTITY PERSON > OUTBREAK REFERRAL > MEDICATION > ELECTRONIC LOCATION TELEPHONE LOCATION POSTAL LOCATION PHYSICAL LOCATION OBSERVATION > SPECIMEN > CASE PUBLIC HEALTH NOTIFICATION ACTIVITY RELATIONSHIP > LOCATION RELATIONSHIP PARTY TO PARTY RELATIONSHIP > ACTOR PARTICIPATION > PARTY LOCATION PARTICIPATION HEALTH RELATED ACTIVITY > 1 0..* +associates 1 +associates_to 0..* 1 +is_target_for 1 +relates 0..* 1 +is_source_for 1 +relates 0..* PARTY > 0..* 1 +is_target_for 0..* +relates to 1 0..* 1 +is_source_for 0..* +relates to * +associates 1+associates_to 0..* 1 +associates_to 0..* +associates 1 MATERIAL RELATIONSHIP > MATERIAL LOCATION PARTICIPATION TARGET PARTICIPATION > 1 0..* +associates 1+associates_to 0..* 1 +associates 1+associates_to 0..* MATERIAL RESPONSIBILITY 0..* 1 +associates_to 0..* +associates 1 MATERIAL > 0..* 1 +is_source_for 0..* +relates 1 0..* 1 +is_target_for 0..* +relates 1 0..* 1 +associates_to 0..* +associates 1 0..* associates_to 0..* +associates * 1 +associates_to 0..* +associates 1 INTERVENTION LOCATION INFORMATION 0..* 1 +associates 0..* +associates_to * +is_source_for 1 +relates 0..* 1 +is_target_for 1+relates 0..* 1 +associates 1 +associates_to 0..* associates_to 0..* +associates 0..1

12 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 12 Revised Party to Party Relationship Party to Party Relationship Party Party Individual Non-Person Living Organism Non-Person Living Organism Person Person Formal Organization Formal Organization Informal Organization Informal Organization Organization New! PHCDM Parties Subject Area

13 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 13 HL7 RIM Change Proposals Desired Changes to the RIM –Add Informal Organization as a specialization of Organization –Add Formal Organization as a specialization of Organization –Add Individual as a specialization of Stakeholder –Make Person a specialization of Individual –Make Living Subject a specialization of Individual Additional Changes to the RIM –Change the name of Stakeholder to Party –Change the name of Stakeholder Affiliation to Party Affiliation

14 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 14 Public Health High-Level Process Model Surveillance Planning –Identify the health-related problem to be addressed –Understand the setting in which surveillance and response activities will take place –Define the scope of surveillance –Develop policies and procedures for conducting surveillance Case Monitoring –Identify parties meeting case definitions and record information about them –Report cases to responsible parties –Analyze data to identify problems and trends –Investigate and confirm suspected cases –Communicate results of analyses and investigations Disease Intervention –Take action to prevent or control disease –Evaluate usefulness of surveillance and effectiveness of outbreak response activities

15 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 15 PHCDM Jun-Dec 2000 Objectives Develop and implement a PHCDM change management process Finalize the PHHPM process decomposition and its mapping to the PHCDM Develop a procedure for transforming the PHCDM into project specific database implementations Implement automation to support the mapping of project specific database implementations to the PHCDM Complete harmonization of the PHCDM with the HL7 RIM Adopt the HL7 vocabulary processes and begin to define PHCDM vocabularies

16 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 16 NEDSS Cooperative Agreement Initiatives

17 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 17 PHCDM and NEDSS The PHCDM project is one of many interrelated activities supporting CDCs National Electronic Disease Surveillance System (NEDSS) initiative. The long-term vision for NEDSS is a collection of complementary computerized information systems that automate the process of gathering health data, facilitate the monitoring of the health of communities, assist in the analysis of trends and detection of emerging public health problems, and provide information for setting public health policy. The focus of the NEDSS initiative is the development, testing, and implementation of information management technology standards that will support more complete and comprehensive integration of computerized health information systems for use in public health.

18 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 18 NEDSS Systems Architecture Brings structure, standards and interoperability to the information systems elements of surveillance Allows the latitude for states and local health departments to do specific implementations and fulfill public health needs Is respectful of local / state / federal data flow issues Provides a structure around which CDC systems can be integrated Facilitates the ready exchange of comparable data and reports between public health organizations without reprogramming

19 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 19 Implement an integrated data repository able to be patient centered, non-categorical support thick client and web applications (ODBC, JDBC and ANSI SQL) Integrated State / Local Data Repository

20 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 20 Implement a security system and appropriate security policies (Internet-based, with a firewall and certificates or tokens) Security Integrated State / Local Data Repository

21 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 21 Conduct and support web browser-based data entry and data management. Internet presentable, but not necessary Multi-tiered including an application server to run web forms from others State Health Department Local Health Department Or Clinical Site Security Integrated State / Local Data Repository

22 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 22 Accept, route and process electronic HL7 messages containing laboratory and clinical content (LOINC, SNOMED). Clinical Database Electronic Laboratory Messages HL7 Security Integrated State / Local Data Repository State Health Department Local Health Department Or Clinical Site

23 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 23 Develop active data translation and exchange (integration broker) functionality (XML, DTDs HTTPS). Clinical Database CDC and Other Health Depts. XML Data Exchange Electronic Laboratory Messages HL7 Security Integrated State / Local Data Repository State Health Department Local Health Department Or Clinical Site

24 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 24 Develop data reporting and visualization capability (messaging and import/export ODBC, JDBC, ANSI SQL). Clinical Database CDC and Other Health Depts. XML Data Exchange Electronic Laboratory Messages HL7 Reporting, GIS and Analysis Security Integrated State / Local Data Repository State Health Department Local Health Department Or Clinical Site

25 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 25 Implement a shareable directory of public health personnel (LDAP). Clinical Database Shareable Directory of PH Personnel CDC and Other Health Depts. XML Data Exchange Electronic Laboratory Messages HL7 Security Integrated State / Local Data Repository State Health Department Local Health Department Or Clinical Site Reporting, GIS and Analysis

26 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 26 Develop transportable business logic capability (COM, CORBA, EJB). Clinical Database CDC and Other Health Depts. XML Data Exchange Electronic Laboratory Messages HL7 Security Integrated State / Local Data Repository State Health Department Local Health Department Or Clinical Site Shareable Directory of PH Personnel Transportable Business Logic Reporting, GIS and Analysis

27 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 27 NEDSS System Architecture Elements Conduct and support web browser-based data entry and data management. Accept, route and process electronic HL7 messages containing laboratory and clinical content. Implement an integrated data repository. Develop active data translation and exchange (integration broker) functionality. Develop transportable business logic capability. Develop data reporting and visualization capability. Implement a shareable directory of public health personnel. Implement a security system and appropriate security policies.

28 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 28 NEDSS Cooperative Agreement Initiatives Assessment and Planning – Assess current information systems personnel and technical infrastructure, evaluate that infrastructure against the NEDSS systems architecture and develop plans to migrate to the NEDSS architecture as needed. Element Development – Implement between one and four of the NEDSS system architecture elements and use in the setting of identified public health activities. Charter Sites - Conduct activities to implement and demonstrate the fully described systems architecture. Charter sites will receive funds for implementation of up to four system architecture elements and to ensure that new and existing elements work together as an integrated whole by prototyping the use of the full systems architecture to supply validated data for existing surveillance systems.

29 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 29 Availability of Funds Approximately $9,300,000 is available in FY 2000 to fund approximately 45 total awards 35 NEDSS Planning and Assessment awards, $65, , NEDSS Element Development Awards, $200,000 - $730, NEDSS Charter Awards, $600,000 - $1,200,000 Supplemental awards will begin on or about September 30, 2000 Applicants may request time-limited specialized technical consultation, software, and equipment as direct assistance, in lieu of a portion of financial assistance.

30 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 30 NEDSS Development Coordination

31 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 31 Development Coordination SDG SME SDG SME Shared Components and Standards Shared Components and Standards SDG SME SDG SME SDG SME SDG SME Shared Components and Standards Shared Components and Standards Site 1Site 2Site 3 Project Specific Intra- Enterprise Inter- Enterprise

32 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 32 Development Coordination Example Core Demographic Database Electronic Lab-based Reporting NETSS Demographic Data Subject Matter Experts Lab Subject Matter Experts Case Reporting Subject Matter Experts Shared Components and Standards Web based UI, HL7, IDR, XML, Business Logic, visualization, Directory, Security Shared Components and Standards PHCDM, CIPHER, Vocabulary, Architecture, PHHPM Project Specific Intra- Enterprise Inter- Enterprise

33 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 33 People (Roles) Project Mangers Project Sponsors Project Liaisons Technical Experts Subject Matter Experts Component Sharing Facilitators

34 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 34 Process Project plans, phases, tasks, sub-tasks, and activities Policies and procedures for shared components and standards Project / program monitoring and status reporting Inter-project dependencies and coordination Shared components development and maintenance Shared component refinement and implementation

35 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 35 Technology Analysis, design, and construction tools Meta-data repositories Repository management software Registries and directories Project management tools Desktop publishing tools

36 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 36 Technology ProcessPeople Development Coordination PPT

37 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 37 Transforming the PHCDM for the IDR Define the implementation subset of the PHCDM Expand complex, interval, and repeating attributes Add / modify classes, attributes, and relationships Document data integrity constraints Identify class keys and inversion entries Normalize the implementation subset Define implementation tables and columns Denormalize the implementation subset Implement enforcement of data integrity constraints Document departures from the published PHCDM Domain Project Teams IDR Project Team

38 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 38 Allocating Responsibility Define the implementation subset of the PHCDM Expand complex, interval, and repeating attributes Add / modify classes, attributes, and relationships Document data integrity constraints Define the implementation subset of the PHCDM Expand complex, interval, and repeating attributes Add / modify classes, attributes, and relationships Document data integrity constraints Identify class keys and inversion entries Normalize the implementation subset Define implementation tables and columns Denormalize the implementation subset Implement enforcement of data integrity constraints Document departures from the published PHCDM Core Demographic Database Electronic Lab-based Reporting Integrated Data Repository

39 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 39

40 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 40 eSG Participation in NEDSS Ongoing PHCDM development and implementation Application of PHCDM to NEDSS initiatives: –Accept, route and process electronic HL7 messages containing laboratory and clinical content –Implement an integrated data repository Assistance with NEDSS development coordination: –Shared component/standard use facilitation –Program/project monitoring and status reporting –Inter-project dependencies and coordination

41 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 41 Ongoing PHCDM Development and Implementation Develop and implement a PHCDM change management process Finalize the PHHPM process decomposition and its mapping to the PHCDM Develop a procedure for transforming the PHCDM into project specific database implementations Implement automation to support the mapping of project specific database implementations to the PHCDM Complete harmonization of the PHCDM with the HL7 RIM Adopt the HL7 vocabulary processes and begin to define PHCDM vocabularies

42 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 42 Application of PHCDM to NEDSS Initiatives Core Demographic Database Projects and Electronic Laboratory-based Reporting –Develop of a project-specific logical data models based upon the PHCDM –Coordination of vocabulary development –Development of HL7 XML message specifications Implementation of integrated data repositories –Development of a physical data model based upon project specific logical data models

43 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 43 Assistance with NEDSS Development Coordination Shared component/standard use facilitation –PHCDM, PHHPM, HL7 Vocabularies –Education and mentoring Program/project monitoring and status reporting –Project planning assistance for data related initiatives –Program level monitoring for data related initiatives Inter-project dependencies and coordination –Assistance in identification of inter-project dependencies –Assistance in coordination of inter-project dependencies

44 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 44 Identification of Next Steps

45 January 27, 2000PHCDM Governments Project Special Interest Group Presentation 45 Questions


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