1. Public Health Reporting Initiative: Stage 2 Draft Roadmap

2. Stage 2 Roadmap Value Timeline / Phases Phase Descriptions Outcomes / Deliverables

3. Stage 2 Value Proposition Identify the reusable data elements and structures to streamline development of implementation guides Define the core functional infrastructure required to both send and receive public health reports Promote interoperability across health information systems critical to public health reporting

4. Following the S&I Framework Process – Use Case to Standards Harmonization to Specification User Story / Use Case Development Data Dictionary Update Data Model Analysis and Update You Are Here Stage 1Stage 2 2/293/143/284/11 4/25 5/9 5/23 2/15 2/1 1/17 1/3 Standards Analysis & Harmonization Functional Requirements Pilot Readiness Assessment 6/6 6/20 7/47/18 8/1 8/158/29 Implementation Guide Development

5. 1.Assess functional requirements for public health reporting and make updates that are based on input from 5 domains Domain Working Groups Timeline: TBD Deliverables: Domain Level Functional Requirements Step 1: Functional Requirements Analysis

6. KEY DECISION: Which data elements must be machine-readable? Based on the definition and user needs –Determine which data elements are important to be machine-readable before 2018 –If Public Health information management systems are NOT expected to be READY to manage reports based on the machine readability of a data element by 2018, it is a LOW priority –If Public Health information management systems ARE expected to be ready to manage reports based on machine readability by 2018 it is a HIGH priority if it greatly improves report routing and subsequent action MODERATE priority if it would only somewhat improve these factors Functional Requirements workgroups Deliverable: list of high & moderate priority data elements. High, and possibly moderate, will be targeted to be constrained to machine- readable code in Stage 3

7. Step 2: Identify data elements and add to S&I Clinical Elements Data Dictionary 1.Identify data elements for each user story –For example, this can be done by reviewing forms in current use and through further dialog with submitters 2.Identify data elements that appear in multiple user stories and harmonize their names and definitions 3.Identify data elements not in Clinical Element Data Dictionary 4.Add data elements and definitions to CEDD Vocabulary and Terminology Group Timeline: TBD Deliverable: updated (augmented) CEDD, Repository of data elements and value sets for 5 domains (e.g. RCMT), Map to EHR Source Information (e.g. CSTE Common Core List of Data Elements; Structured CSTE Position Statements)

8. Step 3: Data Modeling and Analysis 1.Map data elements to existing functional public health and clinical domain models 2.Where necessary, add terms and concepts to those models 3.Identify requirements for significant model enhancements Data Modeling / Terminology workgroup Timeline: TBD Deliverable: proposed updates to key data models (e.g. S&I data models, FHA Public Health Reporting Model, HL7 DAM)

9. Step 4: Standards Analysis and Harmonization 1.Scan harmonization artifacts for reuse (data elements, value sets, concepts, S&I simplification) 2.Develop list of candidate standards applicable to use case requirements, including relevant vocabularies 3.Make recommendations to SDOs if needed (responsible: Vocabulary and Terminology Group) Timeline: TBD Deliverables: Inventory of candidate standards; Harmonization Criteria; Standards Fit Analysis; Recommendations for potential SDO modifications

10. Step 5: Technical Implementation Guide / Specification 1.Develop Implementation Guide with added reconciled data elements. 2.Define value sets for all Common Elements –Compare available code sets for their alignment to priority public health data elements –Pick the code set with the greatest alignment –ID missing values from the selected code sets, and submit these to the code set SDO Vocabulary and Terminology Harmonization WG Duration: TBD Deliverables: Technical Implementation Guide (TIG); Test tools and procedures; Value sets to be assigned for each required data element

11. Step 6: Pilot Readiness Assessment 1.Determine which partners and systems will be ready to receive standardized electronic reports by 2016 This work will be done by Domain Working Groups Timeline: TBD Deliverable: Readiness Profile / Pilot Engagement Plan

12. Following the S&I Framework Process StepDescriptionOutputs/ArtifactsKnowledge / Skill Sets Functional Requirements Analysis Document implementation requirements per Domain / User Stories 1.Documented functional requirements, including data classes Knowledge of User Stories and supporting user requirements Data Dictionary Development User Story Data Elements Common data elements across user story domains 1.S&I CEDD Recommendation Form Inventory of data elements for 5 domains Knowledge of User Stories and supporting data requirements Data Modeling Map data elements to data model Apply harmonization criteria to each candidate standard to gauge level of fit Select standards for further harmonization 1.Harmonization Criteria (word document) 2.Updates to selected model or data model 3.Recommendations for model Exposure to standards and vocabularies Involvement in SDOs and HIT organizations and Data Modeling Processes Clinicians and public health experts

13. StepDescriptionOutputs/ArtifactsKnowledge / Skill Sets Standards Analysis and Harmonization Scan relevant SDO standards that apply to use case requirements Scan harmonization artifacts for reuse (e.g. CEDD data elements, value sets, concepts, S&I simplification) Develop list of candidate standards applicable to use case requirements, including relevant vocabularies 1.Inventory of candidate standards 2.Environmental Scan of Potential Standards 3.Standards Analysis Knowledge of User Stories and supporting functional requirements Knowledge of current landscape (e.g. people, organizations, programs) Exposure to standards and vocabularies Specification Development Compare available code sets for their alignment to needed public health value sets Pick the code set with the greatest alignment ID missing values from the selected code sets, and submit these to the code set SDO 1.Implementation Guide (word document) 2.Artifacts required for SDO balloting (if necessary) Vendors, pilot participants Clinicians and public health experts Involvement in SDOs and HIT organizations, including knowledge of balloting processes Readiness Assessment Determine which partners and systems will be ready to receive standardized electronic reports by 2016 Solicit use of Implementation Guide for MU Stage 3. 1.Readiness Profile / Pilot Engagement Plan Public Health Program Sponsors Provider Participants EHR Vendors Suppliers Following the S&I Framework Process (cont.)