nikolay lipskiy, md, drph, mba 1, anna orlova, phd 2 and roniqua watkins, bs 1 1osels/phitpo/dippc,...

Nikolay Lipskiy, MD, DrPH, MBA1, Anna Orlova, PhD2 and Roniqua Watkins, BS1

1OSELS/PHITPO/DIPPC, CDC, Atlanta, GA, 2OD, Public Health Data Standards Consortium (PHDSC), Baltimore, MD

Public Health Laboratory (PH-Lab) Electronic Data Exchange :

Business Processes and Interoperability Solutions

http://cdc.confex.com/cdc/phi2011/webprogram/Paper28658.html








ACKNOWLEDGMENTS CDC Office of Surveillance, Epidemiology and

Laboratory Services ONC Standards and Interoperability (S&I)

Framework, Laboratory Reporting Interface (LRI) Public Health Laboratory reporting Sub-group

PHIN Vocabulary and Messaging Community of Practice (VM CoP) and PHIN Technical Assistance Team

Public Health Data Standards Consortium (PHDSC) Association of Public Health Laboratories (APHL) American Health Information Management

Association (AHIMA) Scientific technology Corporation Atlas Public Health IBM Research

Background

The electronic submission of reportable lab results to public health is one of the Electronic Health Record (EHR) Meaningful Use (MU) objectives

Harmonization of health IT (HIT) standards for Public Health Laboratory (PH-Lab) results reporting between clinical care and population health aims to improve emergency response and case reporting

CDC’s Office of Surveillance, Epidemiology and Laboratory Services (OSELS) and PHIN facilitate harmonization of the PH-Lab Reporting across public health

The Public Health Laboratory Report Sub-group of the ONC S&I LRI activity and PHDSC engage partners on assessing existing gaps in the PH-Lab standardization and aligning MU objectives with broader public health needs

Presentation Outline

Preliminary results of the CDC OSELS/PHDSC/APHL/AHIMA project for operationalizing HIT standards PH-Lab data exchangesWhite Paper/Roadmap for PH-Lab Interoperability Building PH-Lab Interoperability

HL7 Public Health Reporting Requirements Standard IHE Integration Profile: Public Health Reporting- PH-LabHL7 Public Health Functional Profile - PH-Lab

PH-Lab and National Health IT Standardization Initiatives

White Paper on PH-Lab Interoperability Efforts to Date:

PH-Lab Collaborative Business Requirements Project (APHL and Public Health Informatics Institute (PHII))

APHL PH-Lab Interoperability Project (PHLIP) CDC PH-Lab Interoperability Solutions and Solution Architecture

(PHLISSA) CDC Meaningful Use Electronic Laboratory Reporting Initiative Reportable Conditions Mapping Tables (RMCT) Initiative HL7 2.5.1 PH-Lab Reporting Implementation Guide ONC S&I Electronic Laboratory Interchange Implementation Guide IHE Laboratory Reporting Integration Profiles for Document-based

(CDA) Laboratory Reports Laboratory Interoperability Collaborative (Surescripts, College of

American Pathologists (CAP)) Ontoreason OPHPR/Lab Ontology Model Project

White Paper on PH-Lab Interoperability Assessment of Content Data Sources

(Examples)

White Paper on PH-Lab Interoperability Assessment of Process Flows for Lab

Preparedness

White Paper on PH-Lab Interoperability Harmonization of Data Standards – RCMT –

Mapping reportable Conditions to LOINC and SNOMED Standards

White Paper on PH-Lab Interoperability Actors:A Public Health Laboratory can have up to 10 different

recipients of similar or identical information such as 1. Other public health laboratories 2. Commercial laboratories3. Primary care providers4. Hospital infectious control practitioners5. Health program directors 6. State public health departments 7. State chief medical/health officer 8. City or county chief medical/health officers 9. State epidemiologists, and 10. Federal agencies

Source: APHL PHLIP Project

White Paper on PH-Lab Interoperability Review of Use Cases:

Source: APHL PHLIP Project

White Paper on PH-Lab Interoperability Interoperability is required for two PH Lab

business processes Receive Test Order Send Test Result

Selected PH-Lab Data Exchange Scenarios:AntraxTularemiaHepatitus B (hep B)Tuberculosis (TB)Influenza

White Paper on PH-Lab Interoperability Methodology to Operationalize PH-Lab

Standards:

PHDSC PH-Lab Project by HIT Standardization Phases, Products and Entities

HIT Standardizati

on Phases

Needs &

Priorities

Development &

Maintenanc

e

Selection &

Harmonization

Testing/Trial Implementati

on

Certification

Deployment

Goals

What should be

accomplished?

What are the standards?

What standards

to use?

Show what can be

accomplished

Certify standards-

based products

Deploy standards-

based products

HIT Standards and

Interoperability Framework Development

Entities

HIT Policy Committee

HIT Standards Committee

S&I Harmonizati

on Framework Initiatives

SDOs(e.g., HL7,

SNOMED (IHTSDO), LOINC,

ASC X12,NUBC,

ISO TC215)

IHE

(FormerlyHITSP, to be superseded

pending ONC decisions)

IHE

Certification Entities(CCHIT,

Drummond Group, Inc)

PHIN

IHE & PHDSC

Deployment Workshops

Standards Documents

Use Cases, CDC ELR Projects

PHII-APHLPHLIP

PHLISSA, RCMT, PHIN

Preparedness Report, etc.

Standards

HL7 2.x Implementa-tion Guides

Interoperability Specifications

Technical Frameworks

Integration Profiles

Test Reports

Functional Profiles

Certification Criteria

Deployment Reports

PHIN Adaption of the ONC Standards and Interoperability Framework

HIT Standardization and PHDSC ProjectsHIT

Standardiza-tion Phases

Needs &

Priorities

Development &

Maintenance

Selection &

Harmonization

Testing /Trial Implemen-

tationCertification Deploy-

ment

Goals What should be accomplished?


What standards

to use?

Show what can be

accomplished

Certify standards-

based products

Deploy standards-based products

Public Health

Domains Undergoing

HIT Standardiza

-tion

BiosurveillanceImmunization

ELR

Public Health Reporting

Newborn Screening

Vital Records


ELR


Newborn Screening

Vital Records

Biosurveillance

ImmunizationELR


Newborn Screening

Vital Records

PH-Lab


Hearing

Vital Records

PH-Lab


Hearing

Vital Records

PH-Lab

Hearing

ONCStandards

and Interopera-bility

Framework

Admin Data

PHDSC ProjectsHITSP ProjectsAHIC/MU

HIT Standardization and PHDSC ProjectsHIT

Standardiza-tion Phases

Needs &

Priorities

Development &

Maintenance

Selection &

Harmonization

Testing /Trial Implemen-

tationCertification Deploy-

ment

Goals What should be accomplished?


What standards

to use?

Show what can be

accomplished

Certify standards-

based products

Deploy standards-based products

Public Health

Domains Undergoing

HIT Standardiza

-tion


ELR


Newborn Screening

Vital Records

BiosurveillanceImmunizationELR/PH-Lab


Newborn Screening

Vital Records

Biosurveillance

ImmunizationELR/PH-Lab


Newborn Screening

Vital Records

PH-Lab


Hearing

Vital Records

PH-Lab


Hearing

Vital Records

PH-Lab

Hearing

ONCStandards

and Interopera-bility

Framework

Admin Data

PHDSC ProjectsHITSP ProjectsAHIC/MU

Building PH-Lab Interoperability

Standards Development HL7 Public Health Reporting Requirements Standard

(structured templates for representing jurisdiction-specific requirements)

Standards Harmonization and Testing IHE Integration Profile: Public Health Reporting- PH-

Lab Testing IHE Laboratory Profiles for Test Result Reports

using CDA documents for selected conditionsCertification of Standards-based HIT Products HL7 Public Health Functional Profile - PH-Lab

(functional requirements and conformance criteria for PH-Lab data exchange with clinical EHR)


Standards Development HL7 Public Health Reporting Requirements

Standard (structured templates for representing jurisdiction-specific reporting requirements)

Approved in May 2011 as an extension to the HL7 Healthcare Quality Measure Framework (HQMF) Standard -- joint work of the HL7 Structured Documents Workgroup and the HL7 Public Health & Emergency Response Workgroup

Will be balloted at HL7 in Nov-Dec 2011


Standards Harmonization and Testing IHE Integration Profile: Public Health Reporting- PH-

Lab Describes PH-Lab data exchanges in the context of public

health business processes for case/outbreak identification, investigation, and management.

Defines Clinical Data Architecture (CDA) documents for selected 5 conditions (antrax, tularemia, hep-B, TB, influenza) using RCMT

Defines interoperability standards for data exchanges

Published for Public Comments in June 2011 by the IHE Quality, Research and Pubic Health Committee

Currently under the Committee Review


Standards Harmonization and Testing (Continued) Testing IHE Laboratory Profiles for Test Result Reports

using using Clinical Data Architecture (CDA) documents for selected conditions

We will specify PH-Lab Report content for testing IHE-Lab Integration Profiles in CDA documents for selected 5 conditions (antrax, tularemia, hep-B TB, influenza)

Testing will be conducted at the IHE Connectathon, January 2012


Certification of Standards-based HIT Products HL7 Public Health Functional Profile – PH-Lab will

define functional requirements and conformance criteria of the HL7 EHR Functional Model for generating laboratory orders and receiving results reportsThe Profile will be developed by the PHDSC EHR-Public Health Task Force during August-November 2011Will be Balloted at HL7 in Nov-Dec 2011 and finalized by May 2012

Certification Criteria for PH-Lab data exchanges will be defined

We will work towards establishing the PH-Lab Certification Process with PHIN and the national certification entities

PHDSC PH-Lab Project by HIT Standardization Phases, Products and Entities

HIT Standardizati

on Phases

Needs &

Priorities

Development &

Maintenanc

e

Selection &

Harmonization

Testing/Trial Implementati

on

Certification

Deployment

Goals

What should be

accomplished?


What standards

to use?

Show what can be

accomplished

Certify standards-

based products

Deploy standards-

based products

HIT Standards and

Interoperability Framework Development

Entities

HIT Policy Committee

HIT Standards Committee

S&I Harmonizati

on Framework Initiatives

SDOs(e.g., HL7,

SNOMED (IHTSDO), LOINC,

ASC X12,NUBC,

ISO TC215)

IHE

(FormerlyHITSP, to be superseded

pending ONC decisions)

IHE

Certification Entities(CCHIT,

Drummond Group, Inc)

PHIN

IHE & PHDSC

Deployment Workshops

Standards Documents

Use Cases, CDC ELR Projects

PHII-APHLPHLIP

PHLISSA, RCMT, PHIN

Preparedness Report, etc.

Standards

HL7 2.x Implementa-tion Guides

Interoperability Specifications

Technical Frameworks

Integration Profiles

Test Reports

Functional Profiles

Certification Criteria

Deployment Reports

On-going Activities ( 2008-now)

Developed methodology for public health participation in HIT standards development & harmonization.

New Activities (2010-11) Develop methodology for public health participation in HIT product testing and certification

Future Activities Develop methodology for evaluation of standard-based HIT products (standards-based HIT products deployment)

White Paper on PH-Lab Interoperability

Year 1 Year 2 Year 3

Harmonize Needs & Standards Test Certify & Deploy


ONC S&I Public Health Reporting Initiative ONC S&I Laboratory Reporting Interchange (LRI)

Initiative and Public Health Laboratory Report Subgroup

ONC S&I Transition of Care Initiative ONC S&I Population Query Initiative Federal Health Architecture Initiative


Join us at the PHI Conference Interoperability Showcase

for demonstrations of interoperability solutions for

PH-Lab data exchanges

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.atsdr.cdc.gov

nikolay lipskiy, md, drph, mba 1, anna orlova, phd 2 and roniqua watkins, bs 1 1osels/phitpo/dippc,...

Documents

public health reporting

phlab standardization

phlab interoperabilityefforts

national health

population health

laboratory services

interoperability si

standardization initiatives