1. Early Hearing Detection and Intervension Workflow Definition (EHDI-WD)

2. Content Creator Content Updater Content Consumer Share

3. XDS Source XDS Registry Facade Secure XDS XDS Repository XDS Consumer XDS Registry BPPC Document Enforces the BPPC constraints by shielding the actual XDS Registry Same web service functionality as the XDS Registry Connects to XDS Sources, Consumers and Repository Not a registry-implementation, but a front-end around the actual XDS Registry No data are stored in the XDS Registry Facade Vince – how do we handle the concent document requirements?

4. Document Source Document Repository Document Registry Document Consumer 1 – Register document 2 – Query Document Set 3 – Retrieve Document Set

5. Early Hearing Detection and Intervention - Workflow Definition (EHDI-WD) Create Hearing Plan of Care Hearing Plan of Care Conduct Hearing Screening Update Hearing Plan of Care Outcome Report| Care Summary Hearing Plan of Care Input documentsOutput documents Tasks (optionality) Discharge Newborn Care Summary Hearing Plan of Care | Standing Order Results Outcome Report Order Request & Consent

6. Care Summary Generator Order Placer Screening Requester Plan of Care Manager Birth Discharge Create HPofC HPofC | Std Order Order Request Outcome Report Update HPofC Care Summary Update HPofC After processing a Result document, the Screening Requester decides (based on local jurisdictional rules and other considerations,) if the baby should be screened again or not) Note: for an XDW workflow, the arrows represent a sharing through XDS* Consent Result Order Request Result

8. Create Hearing Plan of Care COMPLETED Hearing Plan of Care is created TBR meeting Conduct Hearing Screening READY Screening is consented and performed Discharge Newborn COMPLETED Update Hearing Plan of Care COMPLETED FAILED CREATED FAILEDIN-PROGRESSCOMPLETED Obtained Consent Requested Order Returned Results Repeat Screening Outcome Report Is created Care Summary is created FAILED READYIN-PROGRESS Care Summary arrives before Outcome Results Updated Outcome Report Outcome Report Care Summary Hearing Plan of Care is Updated ADT Notification of Birth

9. EHDI-WD workflow steps (Part 1) Create Plan of Care Status: COMPLETED Create Workflow Document EHDI-WD Document PH is notified of birth TaskEvent History TaskEvent: 1 Status: COMPLETED Input: N/A Output: Hearing Plan of Care Create Plan of Care Status: COMPLETED Update Workflow Document EHDI-WD Document Care Plan is generated with demographic info. TaskEvent History TaskEvent: 1 Status: COMPLETED Input: N/A Output: Hearing Plan of Care

10. EHDI-WD workflow steps (Part 2) Create Plan of Care Update Workflow Document EHDI-WD Document Consent is obtained. Output: Signed Consent Conduct Screening Status: CREATED TaskEvent History TaskEvent: 1 Status: CREATED Input: Hearing Plan of Care Output: Signed Consent Create Plan of Care Update Workflow Document EHDI-WD Document Screening is requested. Output: Order Request Conduct Screening Status: READY TaskEvent History TaskEvent: 2 Status: READY Input: Signed Consent Output: Order Request TaskEvent: 1 Create Plan of Care Update Workflow Document EHDI-WD Document Screening is performed. Output: Result Conduct Screening Status: IN_PROGRESS TaskEvent History TaskEvent: 3 Status: IN_PROGRESS Input: Order Request Output: Result TaskEvent: 1 TaskEvent: 2 Create Plan of Care Update Workflow Document EHDI-WD Document Screening outcome is assessed. Output: Outcome Report Conduct Screening Status: COMPLETED TaskEvent History TaskEvent: 4 Status: COMPLETED Input: Result Output: Outcome Report TaskEvent: 1 TaskEvent: 2 TaskEvent: 3

11. EHDI-WD workflow steps (Part 3) Update Plan of Care Status: IN_PROGRESS Create Plan of Care Update Workflow Document EHDI-WD Document Plan of Care is updated Output: Hearing Plan of Care Conduct Screening TaskEvent History TaskEvent: 1 Status: IN_PROGRESS Input: Outcome Report Output: Hearing Plan of Care Discharge Newborn Status: COMPLETED Create Plan of Care Update Workflow Document EHDI-WD Document Plan of Care is updated Output: Care Summary Conduct Screening TaskEvent History TaskEvent: 1 Status: COMPLETED Input: N/A Output: Care Summary Update Plan of Care Status: COMPLETED Create Plan of Care Update Workflow Document EHDI-WD Document Plan of Care is updated Output: Hearing Plan of Care Conduct Screening TaskEvent History TaskEvent: 2 Status: COMPLETED Input: Care Summary Output: Hearing Plan of Care TaskEvent: 1 Update Plan of Care Discharge Newborn