Public Health Reporting Initiative:

Stage 2 Draft Roadmap

Stage 2 Roadmap

• Value• Timeline / Phases• Phase Descriptions• Outcomes / Deliverables

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

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 1 Stage 2

2/29 3/14 3/28 4/11 4/25 5/9 5/232/152/11/171/3

Standards Analysis & Harmonization

Functional Requirements

Pilot Readiness Assessment

6/6 6/20 7/4 7/18 8/1 8/15 8/29

Implementation Guide Development

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

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

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)

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)

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

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

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

Following the S&I Framework Process

Step Description Outputs/Artifacts Knowledge / Skill Sets

Functional RequirementsAnalysis

• 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

Step Description Outputs/Artifacts Knowledge / 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.)