201801 Electronic Case Reporting

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Return to Jan 2018 Proposals

Electronic Case Reporting

Electronic Case Reporting Slides

Submitting WG/Project/Implementer Group

Public Health (PH)

Justification

Electronic case reporting (eCR) has been maturing in the CDA product family, and some preliminary FHIR case reporting specifications have now been developed and are being balloted for comment. This track will explore various aspects of FHIR case reporting as they mature, beginning with trigger code representation and dissemination, initial Electronic Case Report (eICR) and Reportability Response (RR) instance generation, and eventually expanding to distributing decision support logic and other items for the support of reporting and management in future Connectathons. This track could include discussions on additional resource needs for these use cases and discussion of items in the current “For Comment” eCR ballot.

The electronic Case Reporting implementation guide currently in ballot can be found here:

http://hl7.org/fhir/uv/ecr/2018Jan/index.html

Proposed Track Lead

  • John Loonsk
  • Rick Geimer


See Connectathon_Track_Lead_Responsibilities

Expected participants

  • APHL
  • CDC
  • CGI Federal
  • Epic
  • Lantana Consulting Group


Roles

Public Health

Responsible for managing and disseminating trigger codes and decision logic.

Public Health Agency

Agencies that will eventually receive and manage electronic Initial Case Reports (eICRs), and at times send and/or receive Reportability Responses

Intermediaries

Organizations in the information flow between a health care organization and a public health agency. Examples include Health Information Exchanges, the shared platform supported by APHL and CSTE that performs routing, RCKMS decision support and, at times, creates Reportability Responses, etc.

Health Care Organization

Organization that submits electronic Initial Case Reports (eICRs) based on trigger code matches, and receives trigger code updates and Reportability Responses. The health care organization can be supported by an EHR vendor in this role.

eICR Document Creator

Organization responsible for creating an electronic initial case report (eICR) and sending it to an eICR Document Participant. Examples: EHR vendors and specialty reporting companies.

eICR Document Participant

Organization responsible for receiving and processing an electronic initial case report (eICR). Examples: APHL or a public health agency (PHA). The eICR Document Participant may also play the role of a Reportability Response Document Creator.

Reportability Response Creator

Organization responsible for creating a Reportability Response (RR) and sending it to a Reportability Response Document Consumer. Examples: APHL or a public health agency (PHA). The Reportability Response Document Creator may also play the role of an eICR Document Participant.

Reportability Response Consumer

Organization responsible for receiving and processing a Reportability Response (RR). Examples: EHR vendors and specialty reporting companies.). The Reportability Response Document Consumer may also play the role of an eICR Document Creator.

Scenarios

Update Trigger Codes on Public Health FHIR Server

Action: Public Health determines that the current trigger code value sets require an update. The appropriate value sets are updated using PUT. Also update trigger codes as a Bundle of ValueSet resources so they can be updated as a whole set.
Precondition: Original trigger code value sets exist on test server
Success Criteria: Value sets are successfully updated and can be retrieved on demand with GET
Bonus point:

Subscribe to Trigger Code Updates

Action: Provider organization uses Subscription to subscribe to changes to trigger code value sets (or value set Bundle) using any legal notification method.
Precondition: Original trigger code value sets exist on test server
Success Criteria: Provider organization is notified and receives a copy of any trigger code value sets that are updated
Bonus point:

Ingest Trigger Codes into EHR

Action: Provider organization receives a trigger code update, and ingests the trigger codes into their EHR to support case report initiation.
Precondition: Trigger codes updates have been received by provider organization
Success Criteria: Trigger code updates successfully ingested into EHR
Bonus point:

Create eICR Document

Action: eICR Document Creator prepares an initial case report and POSTs it to a FHIR server. This POST may be one of several different transport methodologies supported for exchange with public health.
Precondition: Patient and Encounter resources exist, and sufficient clinical information (Condition, Observation, and other resources) to populate an eICR.
Success Criteria: eICR is successfully posted to a FHIR server and validates against the eCR profiles found here: http://hl7.org/fhir/uv/ecr/2018Jan/profiles.html
Bonus point: eICR is created in response to evaluating trigger codes against patient data. Triggering may occur if an EHR diagnosis or problem code matches a code in the diagnosis trigger code value set, if a lab result code matches a code in the lab result trigger code value set, or if a lab order code matches a code in the lab test order trigger code value set.

Receive eICR Document

Action: eICR Document Creator prepares an initial case report and POSTs it to a FHIR server. This POST may be one of several different transport methodologies supported for exchange with public health. eICRs will be queued. The eICR Document Consumer does a GET on each successive eICR and processes it.
Precondition: eICR exists on a FHIR server.
Success Criteria: eICR is successfully retrieved from a FHIR server and validates against the eCR profiles found here: http://hl7.org/fhir/uv/ecr/2018Jan/profiles.html
Bonus point: a Reportability Response is created in response to the eICR.

Clarification: to be discussed as part of the connectathon what 'getting each successive eICR' means at the API level

Create Reportability Response (RR)

Action: RR Document Creator prepares a reportability response and POSTs it to a FHIR server. This POST may be one of several different transport methodologies supported for exchange with clinical care.
Precondition: eICR on which the RR is based exists and contains sufficient information to create an RR.
Success Criteria: RR is successfully posted to a FHIR server and validates against the eCR profiles found here: http://hl7.org/fhir/uv/ecr/2018Jan/profiles.html

Receive Reportabilty Response

Action: RR Document Creator prepares reportability response and POSTs it to a FHIR server. This POST may be one of several different transport methodologies supported for exchange with clinical care. RRs will be queued. The RR Document Consumer does a GET on each successive RR and processes it.
Precondition: RR exists on a FHIR server.
Success Criteria: RR is successfully retrieved from a FHIR server and validates against the eCR profiles found here: http://hl7.org/fhir/uv/ecr/2018Jan/profiles.html

TestScript(s)

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