1. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Public Health Functional Profile of the HL7 EHR System Functional Model and Standard Brief background April 25, 2011 Presented by: John Ritter HL7 EHR Work Group Co-chair JohnRitter1@verizon.net

2. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Adding to the list of Functional Profiles…. Functional Profiles:  EHR-System Records Management and Evidentiary Support  PHR-to-EHR Health Information Exchange  Long Term Care / Nursing Home  Child Health  Behavioral Health  Emergency Department  Clinical Research  Vital Records (Birth and Death Records)  Public Health Functional Profiles: Early Hearing Detection and Intervention Chronic Diseases and Cancer Surveillance (others coming….)

3. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Overview of the EHR-S FM Standard The EHR-S FM consists of three parts: Direct Care  Doctor places a healing hand on the patient Supportive  Helps the doctor place a healing hand on the patient Information Infrastructure  Provides infrastructure for Direct Care and Supportive

4. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Direct Care DC.1Care Management DC.2Clinical Decision Support DC.3Operations Management and Communication Supportive S.1Clinical Support S.2Measurement, Analysis, Research and Reports S.3Administrative and Financial Information Infrastructure IN.1Security IN.2Health Record Information and Management IN.3Registry and Directory Services IN.4Standard Terminologies & Terminology Services IN.5Standards-based Interoperability IN.6Business Rules Management IN.7Workflow Management Functions describe the behavior of a system in user- oriented language so as to be recognizable to the key stakeholders of an EHR System EHR-S Functional Model at a Glance

5. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. EHR-S Functional Model Function ID Function Name Function Statement Function Description Examples See Also Conformance Criteria

6. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Direct Care (excerpt) IDTypeNameStatementDescription DC.1.5FManage problem list Create and maintain patient- specific problem list A problem list may include, but is not limited to: Chronic conditions, diagnoses, or symptoms, functional limitations, visit or stay-specific conditions, diagnoses, or symptoms. Problem lists are managed over time, whether over the course of a visit or stay… See AlsoConformance Criteria IN.2.5.1 IN.2.5.2 1. The system SHALL display all active problems associated with a patient. 2. The system SHALL create a history of all problems associated with a patient. 3. The system SHALL retrieve a history of all problems associated with a patient. 4. The system SHALL provide a user interface to deactivate a problem. 5. The system MAY provide the ability to re-activate a previously deactivated problem. 6. … Source: HL7 EHR-S FM Direct Care Chapter

7. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Supportive Services (excerpt) Source: HL7 EHR-S FM Supportive Chapter

8. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Information Infrastructure (excerpt Source: HL7 EHR-S FM Information Infrastructure Chapter

9. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Structured Use of Imperatives Regular syntax is: “The system SHALL | SHOULD | MAY do something.” Conditional syntax is: “IF the system does X, THEN the system SHALL | SHOULD | MAY do something.” Dependant SHALL syntax is: “The system SHALL conform to IN.2.2 depending on organizational policy, scope of practice, or jurisdictional law.” “The system SHALL do something” vs. “The system SHALL provide the ability to do something”. For example, you don’t want the system to automatically match patient records – without human review.

10. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Tailoring Conformance Criteria Allow (and prompt) the user to tailor a function to meet a specific need via the key phrase, ”…according to organizational policy, scope of practice, or jurisdictional law”. If universally practiced, there’s no need to tailor the function. If at least one instance where the function needs to be tailored, we add the corresponding key phrase.

11. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Conformance to Profiles

12. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Rules for Shall/Should/May

13. © 2011 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Q & A Sooo… The Public Health Functional Profile of the HL7 EHR System Functional Model and Standard How does it look to you??