Project Page for Electronic Case Reporting

Project Page for Electronic Case Reporting

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• Project co-sponsors
  • Structured Documents (SDWG

• Upcoming Calls/Meeting Information
• link to meetings minutes

Project Information

Links to previous efforts / Background material

• 2009 Case Reporting IG
• S&I Framework Public Health Case Reporting Initiative (PHRI)
  • Case reporting IG
  • Use case document
  • Dataelements

Link to project scope statement

PSS for Electronic Case Reporting

Name the project facilitators

• Project facilitator (1 Mandatory) Maribeth Gagnon (CDC)
• Other interested parties and their roles John Roberts (PHER co-chair, Tennessee Department of Health)
• John Loonsk (Executive Sponsor, CGI Federal)
• Multi-disciplinary project team (recommended)

 ** Modeling facilitators - Eric Haas (Contractor to APHL), AbdulMalik Shakir (Contractor)
 ** Publishing facilitator - Jean Duteau (Hl7 Canada)
 ** Vocabulary facilitator - Riki Merrick (Contractor to APHL)
 ** Domain expert rep - Erin Holt Coyne (Tennessee Department of Health)
 ** Business requirement analyst - TBD
 ** Conformance facilitator (for IG projects) - TBD

Status and Timeline

PSS - Oct 18th Writing assignments are due 10/31 Goal to have a Final draft 11/17 last day for submission for Ballto Nove 28th?

Assignments:

• Purpose – John Loonsk and John Roberts
• Background -- John Loonsk and John Roberts
• Scope -- John Loonsk and John Roberts
• Future work -- John Roberts
• Audience- MariBeth to pull existing information from PHRI
• Approach (use case, actors, processes, data flows swim lanes diagrams, interaction diagrams, etc. -- Laura Conn and Shu McGarvey
• List of templates generated from Trifolia/authoring tool -- Eric Haas
• Appendices (templates, value sets)-- Eric Haas

Inital Ballot Content

Initial Ballot Content for IG: eICR C-CDA IG Initial Ballot Content Format

Link to templates library

Status; Draft Status Date: 11/10/2015

To see template detail click on the link below, navigate to "Templates" tab and select 'PHCR" in the left menu bar. Art Decor provides am HTML table view of the constraints and description of the cda document tempates. If you would like to contribute to authoring the templates, DEs, vocabulary contact Eric Haas

eICR templates library

Issues list and Implications reusing CCDA templates

• Extra stuff we are adding to the base US Realm header and the extra stuff CCDA requires in both US Realm Header and Section and Entry templates summary below

Implications reusing CCDA templates

• Here is a summary of the cCDA template issues – a lot of these will be cleare when we understand what "R" and "RE" means in eICR DEs list

1. eICR required elements not present in C-CDA:
   • Entry template required in EiCR but 0..1 (MAY) in CCDA eg ServiceDeliveryLocation, Indication, Encounter Diagnosis in Encounter Activity and Pregnancy and Social History Observation entry templates in Social History section - implication is won't know why information is missing ( unknown, or ignored) - if want to require then need to constrain these templates.
2. C-CDA required elements not required by eICR:
   • Custodian is required in document header - who is the custodian / Sender (Provider Org) , intermediary (PHCP) or Receiver ( PHA )?
3. C-CDA incompatible with eICR constraints:
   • nullflavor allowed for several eICR Required elements at section level ( Results Section, Problem Section, Medications Section, Encounters Section ) Note that is probably compatible with our definition of required but need to bring up if required means no null flavors ( i.e. Mandatory )
   • How to document constraints for occupation hx or only diagnosis and symptoms without constraining template or valueset?
4. How to indicate Patient is not pregnant. Currently in ccda only assert pregnancy
   • option 1 - use constrained pregnancy template with negation indicator if asserting not Pregnant, and nullflavoe if unknown or Not applicable (too young, old or male)
   • option 2 - use problem observation template and use vocabulary to indicate if pregnant or not pregnant. we elected this one to start
5. Need to review both cardinality and conformance usage for each eICR data element (i.e. which are mandatory - null flavor not allowed)
6. Need to review vocabulary for each Dataelement where applicable.
7. Need to agree on a Title.
8. Template OID - (checking with AK on whether can use the existing 2009 CR OID as root)
9. Trigger code value set still not settled on content and format - stubbed in a short value set showing a variety of conde systems. will need to determine where will be hosted
10. ordered test may not be same as code in observation organizer.

Example CDA Document

Status; Draft Status Date: 11/10/2015

eICR Example Pertussis message zip file include schema and xlst files

eICR Example Pertussis message human readable output

CSTE consensus derived Data Elements

Summary of DataElements mapped to CCDA templates.

Status: Draft

Status date: 20151018

ECR Datalement to MU2105 and CCDA Mappings

Use Case summary descriptions

• Use case diagrams created by Laura/Shu/Janet

Status: Draft

Status date: 20151018

eCR Context diagram and preconditions for use case with PH Intermediary system (e.g., PHCP)

eCR Context diagram and preconditions eCR without a PH intermediary system (eCR sent directly to PH)

• Use case diagrams created by AMS "Use Case diagram as part of producing the abbreviated DAM that I hoped would provide some input to this effort."

Status: Draft

Status date: 20151018

Use Case Diagram

Activity Diagram

Class Diagram

• Use case scenario from ASTHO

Status: Draft

Status date: 20151018

Inital eCR User Case Scenario

Draft DAM Diagrams

• DAM created by AMS

Status: Draft

Status date: 20151102

Word format: initial draft of the eICR Domain Analysis Model

Enterprise Architext format: initial draft of the eICR Domain Analysis Model

Pilots

• ASHTO Informatics Call for Participation in Electronic Case Reporting Pilot

Status: Unknown

Status date: 20151018

Call for Participation

Project Scope Statement Electronic Case Reporting Using the PHCP

Issues/Hot Topics

List of issues

1. Triggers code - currently not in scope for IG but need to be discussed. ( should they be separated IG ?)
   • has been been mapped in template to DocumentationOf and draft valuest consisting of ICD-10, SCT and LN for Diagnosis, Lab Restults and Lab orders.
   • 1:1 trigger to eicr so encounter could generate multiple report for simplest solution
2. Direct reporting to PHA vs intermediate step to PHCP/RCKMS decision suppor- what is scope of IG
   • both in scope
3. Using unconstrained (unchanged) CCDA section and entry templates for initial DSTU of message - will this create issue for PHAs if they require information not relevant to CR?
   • Need to review each element
4. FHIR version of CR resource alongside of SDC FHIR instead of V3 based CDA

Current STU Comment Period

• please visit http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=188 for comments on the current STU.

DRAFT DOT Release Materials

• November 2016
• Please see go to http://www.hl7.org/Special/committees/pher/docs.cfm? for the draft. Documents will be available for review by HL7 members only; if you are not an HL7 member, you will not see this document to review.
• Materials include:

       _readme.txt – outlines the contents of the zip
       IG Volume 1 
       IG Volume 2
       transform folder – transform to render the CDA
       xml folder – sample file and html rendering of sample file

• There are GForge links to the Schema and Schematron in the readme and also in Volume 1.

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