1. APHL-PHDSC Collaboration Standards in the laboratory realm November 9 th, 2012 PHDSC Annual Meeting Riki Merrick, MPH Contractor to Association of Public Health Laboratories

2. Overview Collaboration between APHL and PHDSC 2011-2012 White Paper with 2 parts – Standards in use in the Public Health Laboratory (PHL) domain – Roadmap to HIT standardization for PHL 2011-2013 PH functional model for EHRsystems for PHL 2012-2013 PHL result reports using CDA templates PHDSC 2012

3. White Paper – Part 1 http://www.phdsc.org/standards/pdfs/PHDSC-APHL_PHL_Standards_White-Paper_Part- 1FINAL_v1.pdf PHDSC 2012

4. White Paper – Part 2 PHDSC 2012 http://www.phdsc.org/standards/pdfs/PHDSC-APHL_PHL_Standards_White- Paper_Part-2FINAL_v1.pdf

5. PHDSC HIT Standardization Framework CSTE 2012

6. PH functional model for EHRsystems Defines EHRsystem requirements to support data exchange with PHL HL7 working group expansion of existing functional standard to include several new PH domains, including PHL PHDSC facilitated calls with full domain representation CSTE 2012

7. PH functional model for EHRsystems (cont.) VR = Vital Records EDHI = Early Hearing Detection and Intervention CAN = Chronic Disease Cancer Surveillance ODIF = Occupational Disease, Injury, and Fatality HS = Health Statistics DVT = Deep Vein Thrombosis and Pulmonary Embolism BD = Birth Defects AE = Adverse Events PHDSC 2012

8. CDA templates for lab result reports PHLs should consider using CDA: EHRsystems natively produce CDA PHLs need human readable results to support CLIA compliance but PHL result reports usually covered by HL7 v2 messages, where data is highly structured so existing CDA templates may need extensions PHDSC 2012

9. CDA templates for lab result reports Builds on PH case reporting project using CDA Creation of CDA lab result model in the Model Driven Health Tool (MDHT) to create the base template Application of the base template to 15 disease test cases – proposed are: PHDSC 2012 InfluenzaSalmonella Bordetella pertussisNeisseria meningitidis Mycobacterium tuberculosisWest Nile virus Blood leadStaphlyococcus Hepatitis (A, B, C)Streptococcus pneumoniae Chlamydia trachomatisNeisseria gonorrhoeae Haemophilus influenzaeBacillus anthracis Francisella tularensis

10. Benefits of Collaboration Expertise on both sides is combined – PHDSC: Advocacy Policy development activities (HITSP) Standards development CDA Implementation testing – APHL: Advocacy and informatics policy Standards development Lab domain expertise HL7 message implementation guide development and deployment Hands on Technical Assistance program for data exchange implementations PHDSC 2012

11. Questions/Contact Riki Merrick rmerrick@iconnectconsulting.com Michelle Meigs michelle.meigs@aphl.org PHDSC 2012

12. Glossary PHDSC 2012 AEAdverse Events APHLAssociation of Public Health Laboratories BDBirth Defects CANChronic Disease Cancer Surveillance CDAClinical Doument Architecture CLIAClinical Laboratory Improvement Amendments DVTDeep Vein Thrombosis and Pulmonary Embolism EDHIEarly Hearing Detection and Intervention EHRElectronic Health Record EINEmployer Identifaction Number HIPAAHealth Insurance Portability and Accountability Act HITHealth Information Technology HL7Health Level Seven HSHealth Statistics IHEIntegrating the Healthcare Enterprise LOINCLogical Observation Identifiers Names and Codes MDHTModel Driven Heatlh Tools NPINational Provider Identifier ODIFOccupational Disease, Injury, and Fatality PHPublic Health PHDSCPublic Health Data Standards Consortium PHIN MSPublic Health Information Network Messaging Service PHLPublic Health Laboratory RIMReference Information Model SNOMEDSystematized Nomenclature of Medicine UCUMUnified Code for Units of Measure VRVital Records