1. Public Health Data Standards Consortium http://www.phdsc.org 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.  Recruitment: Aug – Sept ✔  2 State participants  State observers  Pilot Design: November – December 2012 ✔  Implementation: January 2012   Testing: February – March 2012  Connectathon – Feb 1, 2013  Field (sample data) – Feb 28, 2013  Operational (real patient data) – March 14, 2013  Final Report: March - May 2013  Draft Project Report  Final Project Report – May 2013 CDA EHDI Pilot Project: Timeframe for ND

4.  Recruitment: Aug – Sept ✔  2 State participants  State observers  Pilot Design: November – January 2012   Implementation: January 2012  Testing: January – February 2012  Field (sample data)  Operational (real patient data)  Final Report: March - May 2013  Draft Project Report – March 2013  Final Project Report – May 2013 CDA EHDI Pilot Project: Timeframe for OR

5. NORTH DAKOTA Finalize recruitment of vendor partners – Jan 11 Finalize work plan – Jan 11 Confirm NHS/EHCP data meets EHDI reqs - Jan 18 OREGON Complete gap analysis/data mapping – Jan 24 Confirm system ability to send NHS data - Jan 24 Define architecture for reporting - Jan 24 Finalize work plan – Jan 24 CDA EHDI Pilot Project: Next Steps

6. PARTICIPANTS FOR NEXT PILOT Start recruitment of vendor partners Confirm NHS/EHCP data meets EHDI reqs Confirm system ability to send data Review architectures for reporting CDA EHDI Pilot Project: Next Steps

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

8. Public Health Gateway (OZ) CDA NHS Outcome Report (internal) Birthing Facility EHR (Cerner) Continuity of Care Document (CCD) State EHDI Information System (OZ) CDA-based Actor Diagram using RFD North Dakota - EHDI Reporting Design Form Filler Form Manager Continuity of Care Document (CCD) Or Other CDA Document (Labor & Delivery Summary) Form Receiver Form Delivery of Form along with pre-population data bound to the form PCP/ Pedia- trician (Greenway) Care Plan Document Reliable Interchange (XDR) CDA-based Actor Diagram using XDR

9. Public Health Gateway CDA NHS Outcome Report Birthing Facility EHR (Epic 2012) Continuity of Care Document (CCD) State EHDI Information System (Orion Rhapsody, Locally Developed) CDA-based Actor Diagram using IHE RFD Oregon - EHDI Reporting Design – Option #1 Use Form Manager to collect/send data Form Filler Form Manager Continuity of Care Document (CCD) Or Other CDA Document (Labor & Delivery Summary) Form Receiver Form Delivery of Form along with pre- population data bound to the form

10. Birthing Facility EHR (Epic 2012) State EHDI Information System (Orion Rhapsody, Locally Developed) Oregon - EHDI Reporting Design – Option #2 Send CDA directly from EHR to EHDI IS CDA NHS Outcome Report CDA – HL7 Clinical Document Architecture NHS – Newborn Hearing Screening EHDI – Early Hearing Detection & Intervention

11. Public Health Gateway (TBD) CDA NHS Outcome Report Birthing Facility EHR (Epic 2012) Continuity of Care Document (CCD) State EHDI Information System (Orion Rhapsody, Locally Developed) CDA-based Actor Diagram using RFD Oregon - EHDI Reporting Design – Option #3 EHR sends CCD with Intermediate Transform Form Filler Form Manager Continuity of Care Document (CCD) Or Other CDA Document (Labor & Delivery Summary) Form Receiver Form Delivery of Form along with pre- population data bound to the form

12. Data Requirements Develop data dictionary of data elements Map between PH EHDI reqs & CDA Map EHR data elements to EHDI reqs Provide results: gaps and overlaps

13. Addressed by Early Hearing Care Plan RecordTarget DocumentationOf/SerivceEvent InformationRecipient RecordTarget/guardian RecordTarget/patientRole/id RecordTarget/languageCommunication RecordTarget/patientRole/organization Newborn Hearing Screening Procedures Newborn Hearing Screening Results NHS CDA Document Perspective Header Body

14. Glossary CCD – HL7 Continuity of Care Document CDA – HL7 Clinical Document Architecture EHCP – IHE Early Hearing Care Plan HL7 – Health Level 7 IHE – Integrating the Healthcare Enterprise NHS – Newborn Hearing Screening RFD – IHE Retrieve Form for Data Capture

15. Questions? CDA EHDI Pilot Project