1. Standards and Vital Statistics: Building an HL-7 Vital Events Message Delton Atkinson, MSPH, MPH, PMP NCHS Consultant Lockheed Martin Information Technology June 8, 2004

2. Session Agenda Importance of Messaging – National Health Information Infrastructure History of Vital Events Messaging Accomplishments to Date Where Do We Go Next

3. Budget Bureau Prediction “….it can not be assumed that the need for adequate vital records will disappear after the war emergency is ended; on the contrary, the course of social evolution points to continually increasing needs for official records of the existence, identity and status of individuals, and for statistics based on such records. “

4. In the World of Technology….. Just Imagine….?

5. Just Imagine…..? Government to Customer Transactions

6. Just Imagine…..? Government to Customer Transactions Government to Business Transactions

7. Just Imagine…..? Government to Customer Transactions Government to Business Transactions Government to Government Transactions

8. National Health Information Infrastructure (NHII) Report in December 2001 Heart of the Vision: “…sharing information and knowledge appropriately so it is available to people when they need to make the best possible health decisions”

9. Basic Elements of the NHII Values Practices and relationships Laws and regulations Privacy Standards Technology Systems and Applications

10. Element #2: Practices & Relationships Facilitate the flow of health information and knowledge and communication both within sectors and between them Changes in information sharing practices

11. Element #5: Standards Building blocks of effective information systems Essential for effective and efficient public health and health care delivery systems HIPPA put into motion activities that move health information toward standardization.

12. Advancing Health IT: National Goals Assuring that most Americans have electronic records within 10 years HL-7 level functional model and standards for electronic records Interoperable health information infrastructure Creation of Office of Health Information Technology in 2004, with Dr. David J. Brailer as first director.

13. Where is Vital Statistics in this Context? Brainstorming about vitals, standards, and communication in 2001 Defining Events – Appeal to be a part of NEDSS – Conceptualization of EVVE

14. Summer 2001 New Mexico Annual Meeting – Standards-based approach to vital statistics – Re-engineering launched Joint Meeting with CDC Informatics Officials Vital Statistics Messaging is born.

15. Fall of 2001 First Working Group formed to craft a vital events message – NAPHSIS – CDC – CDC-sponsored contractor NEDSS Cooperative Agreement w/ NAPHSIS – Travel to NEDSS Conference – Participate in standards setting coalitions – Educate membership about NEDSS & standards

16. Summer of 2002 Formation of the Re-engineering Oversight Committee, which established 6 subcommittee: EDRS, EBRS, POS, Data Analysis, Reports/Files/Outputs, and IT. Vital Events Messaging Initiative assigned to IT Committee IT Sub-committee creates HL-7 Working Group

17. Spring 2003 HL-7 Working Group presents to PHDC PHDC agrees to help New Messaging Work Group formed – HL-7 Working Group – PDC – NCHS/DVS – CDC-Atlanta – Consultants PDC secures funding for part-time staff

18. Accomplishments Constructed electronic message specifications for births and deaths Agreement reached on differences in vocabularies (e.g., race and ethnicity) and maintenance of vocabularies. – HL-7 to maintain highest level of R&E codes – CDC to maintain granular levels

19. Accomplishments, etc. Selected births as the first vital event to seek standard for. Selected HL-7 Version 3 as the tool for the development of the standard message. Briefing of HL-7 Accrediting body completed. Assigned to Public Health & Emergency Response Special Interest Group

20. Next Steps Develop a white paper on the business case on messaging for the vital statistics community Develop a pilot project on messaging Develop the first HL-7 implementation guide Marshal the first package through the HL-7 approval process Implement the PHIN messaging system at NCHS.

21. Why Vital Statistics Messaging? National standards for health information exchange are coming Health information systems—both private and public– will have to follow these national standards. More importantly,

22. With Standards It is better to lead than follow !