1. Public Health Data Standards Consortium http://www.phdsc.org

2. Public Health Data Standards Consortium CDA EHDI Pilot Project
Clinical Document Architecture (CDA) for
Public Health
CDA State EHDI Pilot Projects

3. CDA EHDI Pilot Project: Timeframe
Aug - Sept– Recruitment ✔
2 State participants (To be determined)
X State observers (To be determined)
November/December 2012 – Pilot Design 
January/February 2012 – Implementation
January 31/February 28, 2012 – Testing
March, 2013 – Draft Project Report
May 2013 – Final Project Report

4. CDA EHDI Pilot Project: Next Steps
FOR PARTICIPANTS
Finalize recruitment of vendor partners – by Dec 14
Confirm system capability to send/receive report
Ready State Team for weekly calls (Staff and System Vendors)
Confirm data requirements – by Jan 4
Define architecture for reporting
Participate in design calls
Confirm report meets EHDI program requirements

5. CDA EHDI Pilot Project: Next Steps
FOR PHDSC TEAM
By Dec 14th
Announce results of technical assessment and selection of Pilot Participants
Setup and hold weekly State Technical Team Pilot Implementation meetings
Finalize State technical capabilities and secure vendor commitment
Complete NHS data model
By Jan Call
Define State-specific architecture for data reporting
Harmonize and confirm State-specific data requirements/schema
Define State-specific pilot timelines and work plan
Start development of State projects designs 
Educate Participants and Observers about Model Driven Health Tools (MDHT)

6. State Work Plan Task Point of Contact Due Date
Conduct data mapping from CDA NHS Outcome Report model to EHR Data/Form
PHDSC, State Team
TBD
Identify program data requirements
State Team
Complete data/code mapping
PHDSC
Create NHS form in EHR
EHR vendor
Create CDA NHS Outcome Report from Form Data in EHR
Transmit CDA NHS Outcome Report directly or through HIE
HIE vendor
Import CDA NHS Outcome Report into PH EHDI IS
PH EHDI IS vendor
Test implementation
PHDSC, State Team, Vendors

7. CDA EHDI Pilot Project: State-Specific Use Case
Newborn Hearing Screening
Newborn, Caregiver, Clinicians, Public Health Program Staff
EHR, HIE, Public Health (PH) EHDI IS
Actors:
Business Actors
Technical Actors
Data Categories
Child is delivered.
Clinician conducts initial physical exam
Newborn is due for <hearing test>
Clinician orders an <hearing test>
Hospital staff conducts <hearing test>
Hospital staff enter data on the <hearing test> in the EHR database and generate <Newborn Hearing Screening (NHS) Outcome Report>
Information is electronically sent on <NHS Outcome Report > to the PH EHDI IS directly or via HIE
PH program EHDI IS receives Notification of Report Availability
PH programs’ staff reviews the report and create PH EHDI IS record on a child in PH EHDI IS and upload <NHS Outcome Report > in PH EHDI IS
PH IS sends Acknowledgement of Receipt of the Report to EHR directly or via HIE.
1&2. Demographics, Labor & Delivery Record, Newborn EHR
3. Consent
4. Standing Order
5. Hearing Test Results
6. Hearing Test Results, NHS Outcome Report
7. NHS Outcome Report
8. Notification of Report Availability
9. Updated Pubic Health EHDI Record
10. Acknowledgement of Receipt
Flow of Events
Pre-Conditions:
EHR System, Health Information Exchange (HIE)
Post-Conditions:
Public Health Information System <EHDI IS>
Preferred Timing
Daily updates

8. Oregon - EHDI Reporting Design
Birthing Facility
EHR
OHSU,
Legacy Health
(Epic 2012)
Public Health Gateway
(TBD)
State EHDI
Information System
Oregon
(Orion Rhapsody, Locally Developed)
Continuity of Care Document (CCD)
CDA NHS Outcome Report
Continuity of Care Document (CCD)
Form Filler
Form Manager
Form Receiver
Or Other CDA Document
(Labor & Delivery Summary)
Form
Key:
CCD: Continuity of Care Document
CDA: Clinical Document Architecture
OHSU: Oregon Health & Science University
NHS: Newborn Hearing Screening
RFD: Retrieve Form for Data Capture
Delivery of Form along with pre-population data bound to the form
CDA-based Actor Diagram using RFD

9. North Dakota - EHDI Reporting Design
North Dakota EHDI Program
Birthing Facility
EHR
Trinity
(Cerner)
NANI & PCD-01
Public Health Gateway
(OZ)
State EHDI
Information System
(OZ)
Early Hearing Care Plan (EHCP)
PCP/ Pediatrician
TBD
(Greenway)
Key:
EHCP: Early Hearing Care Plan
NANI: Newborn Admission Notification Information
PCD-01: Patient Care Device - Communicate PCD Data
XDR: Cross-Enterprise Document Reliable Interchange
Document Reliable Interchange (XDR)
CDA-based Actor Diagram using XDR