1. Vital Registration and Care Coordination for Newborn Hearing Screening
Care Theme: Maternal & Newborn Health
Vital Registration and Care Coordination for Newborn Hearing Screening
Us Case 5
Interoperability Showcase
In collaboration with IHE
Use Case 16

2. Care Theme: Maternal & Newborn Health
Use Case 16: Vital Registration and Care Coordination for Newborn Hearing Screening
Primary Goal: Demonstrates information flow related to vital registration, newborn hearing screening, care coordination, and quality measures that occur after baby is delivered.  Newborn hearing screening is conducted after delivery. Results are transmitted to state public health's Early Hearing Detection and Intervention (EHDI) information system (IS) to prepare an Early Hearing Care Plan (EHCP). Care coordination is demonstrated by sharing EHCP with each baby's pediatrician. Demonstrates interoperability between Birthing Facility Electronic Health Record (EHR) and State Vital Records’ IS. Pediatric quality measure as defined by CDC are computed by quality measurement service provider.
Key Points:
The demonstration uses multiple IHE profiles to show exchange of medical information between EHR Systems and the development of long-term, quality health care plans based upon state /government historical information.
Meaningful Use (MU) Relevance: Improving Quality, Safety, Efficiency, and Reducing Health Disparities
Clinical Workflow:
OB/GYN or certified nurse/midwife (CNMW) collects expectant mother’s demographic information and medical history during prenatal care and provides antepartum summary, antepartum history and physical (AP*) documents which will be available to the labor and delivery department when the mother gives birth.
Expectant mother arrives at Birthing Facility where, following delivery, her clinical details from birth and initial post-partum period are captured on Labor and Delivery Summary (LDS) in Birthing Facility EHR. Newborn Admission Notification Information (NANI) on each newborn is sent to EHDI IS as a timely denominator of hospital births. Relevant health information from LDS is sent to pre-populate the Birth and Fetal Death Report (BFDR) electronic form. Clinician reviews and edits information in pre-populated electronic BFDR for completeness and accuracy. Upon approval, the BFDR form information is used to populate state/jurisdiction’s Electronic Birth Registration System.
Birthing Facility EHR sends clinical data to State Public Health to pre-populate electronic Vital Records Facility Worksheet. Completed information is transmitted to jurisdictional authority for birth registration and production and dissemination of local and national birth statistics.
Hearing screening results from Patient Care Device (PCD01) capture and/or from Birthing Facility’s EHR are transmitted to EHDI Program responsible for creating an EHCP. EHCP generated from EHDI-IS communicates individual newborn hearing screening outcome and jurisdiction-specific guidelines for follow-up care to Pediatrician EHR through HIE. Quality Measure Execution (QME-EH) uses NANI and EHCP available in EHDI IS to send to the HIE analytics to measure and monitor Meaningful Use Measure: NQF 1354: EHDI-1a—Hearing Screening prior to Hospital Discharge).
Pediatrician receives and reviews EHCP prior to well-child visit.
CDC/NCHS receives birth certificate information from all vital records jurisdictions. Statistics are collected and analyzed to monitor the demographic and health status of the population and for epidemiologic research.

3. Care Theme: Maternal & Newborn Health
Use Case 16: Vital Registration and Care Coordination for Newborn Hearing Screening
Clinical Workflow:
HIE1| HIE2
HIE2| HIE1
OB/GYN
Collect prenatal care info
2. Labor & Delivery
Collect birth/post-partum info
3. Public Health Reporting
4. Public Health Entity Hearing Screening Received & Evaluated
5. Pediatrician Retrieves EHCP
6. HIE
Computes eMeasures
1. OB/GYN or CNMW collects expectant mother’s demographic information during prenatal care; provides Antepartum Summary and AP documents, which will be available to the Labor & Delivery when mother gives birth.
2 Expectant mother arrives at Birthing Facility where, following delivery, her clinical details from birth and initial post-partum period are captured LDS in Birthing Facility EHR. Relevant medical and health information from LDS will pre-populate BFDR. Clinician reviews and edits information in electronic form for completeness and accuracy. Upon approval, the information from the Form populates the state/jurisdiction’s Electronic Birth Registration System. NANI sends each newborn’s demographics to EHDI IS.
3. Birthing Facility EHR uses Form Manager application from a State Public Health Agency to populate electronic form (Vital Records Facility Worksheet) with clinical data. Once complete, this information is transmitted to the appropriate jurisdictional authority for birth registration and the production and dissemination of local and national birth statistics.
7. CDC/NCHS
Receives info; collects statistics for research
4. Hearing screening results from device capture and/or Birthing Facility’s EHR are transmitted to EHDI Program responsible for creating the EHCP. EHCP generated from EHDI-IS communicates newborn’s hearing screening outcome and jurisdiction-specific guidelines for follow-up care to Pediatrician EHR through HIE. Quality Measure Execution information (QME-EH) is sent to the HIE analytics to measure and monitor Meaningful Use Measure: NQF 1354: EHDI-1a—Hearing Screening prior to Hospital Discharge).
5. Pediatrician receives and reviews Early Hearing Care Plan prior to well-child visit
6. Number of births (denominator) using NANI and the outcome of newborn hearing screening (numerator), are used to compute the percentage of babies receiving screening prior to Hospital Discharge - Meaningful Use eMeasures via HIE Analytic value added services.
7. CDC/NCHS receives birth certificate information from all vital records jurisdictions. Statistics are collected and analyzed to monitor the demographic and health status of the population and for epidemiologic research.

4. Domain Profile Vendors Actors Care Theme: Maternal & Newborn Health
Use Case 16: Vital Registration and Care Coordination for Newborn Hearing Screening
Domain
Profile
Vendors
Actors
IT Infrastructure (ITI)
PIX, PIXv3
Oracle, Intersystems
PIX Manager
PDQ
PDS Server
XCA
Initiating Gateway, Responding Gateway, Registry
XCPD
Initiating Gateway, Responding Gateway
XDS-b
Document Registry, Document Repository
NHIN Connect
Patient Care Coordination (PCC)
APS
GMT, Epic
Content Creator, Content Consumer
LDS
Epic
Content Creator
Quality, Research and Public Health
EHCP
CDC-OZ, GMT
NANI
Epic, CDC-OZ, Intersystems
Subscriber, Manager, Information Source
BFDR
Epic, CDC-OZ, Genesis, Utah DPH, Minnesota DPH
Form Filler, Form Manager, Form Receiver
QME-EH
CDC-OZ, Intersystems
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