201901 Public Health

DRAFT Public Health (Case Reporting, Registries, and Referrals)

Submitting WG/Project/Implementer Group

Public Health (PH) Work Group

Justification

Public health includes a number of use cases involving the exchange of information between Electronic Health Records in clinical care and governmental Public Health Agencies (PHAs) or other extra-clinical organizations. The use cases differ, but they frequently have a number of common design elements as well. Because the data exchange is inherently interorganizational, and because initiating events frequently occur in healthcare, unsolicited “push,” messaging, and other reporting components are important use case needs. This Connectathon will focus on common components like FHIR messaging and clinical infrastructure to support reporting to many different extra-clinical organizations, as well as specific transactions for disease surveillance and chronic disease prevention and management. Electronic case reporting (eCR) has existing CDA product family standards and has a FHIR in-process ballot. This use case will focus on the FHIR subscription dissemination of public health “knowledge distribution” including reporting trigger codes in a PlanDefinition construct and also establishing a path for distribution of reporting criteria and more complex business logic. It will also involve the triggering and creation of the electronic Initial Case Report (eICR) in EHRs, the messaging and exchange of the eICR, and the creation and transmission of Reportability Response information back to providers of care and clinical care reporters as appropriate. The FHIR electronic Case Reporting implementation guide currently in ballot can be found here:

• http://hl7.org/fhir/us/ecr/2018Sep/index.html.

Public health registry reporting shares numerous design elements with electronic case reporting. Some of these elements include the distribution of triggering / reporting rules from public health, appropriate triggering in EHRs, the application of more complex inclusion/exclusion and reporting logic, unsolicited push messaging, supplemental data acquisition, and provider information provisioning. Cancer reporting and others are exploring approaches to implementation that support needed program outcomes from clinical workflow and data and leverage commonalities with other reporting. The CDC Cancer program plans to work on a FHIR physician reporting specification and triggering issues in this Connectathon.

Bidirectional Services eReferrals (BSeRs) are closed-loop exchanges between EHRs in clinical care and mostly extra-clinical social services and lifestyle change programs. There is a FHIR BSeR September ballot with transactions to support the transmission of a referral and response and update communications from the program back to the referring provider. Numerous Centers for Disease Control and Prevention and other agency programs seek to facilitate cessation and prevention programs to increase health and decrease healthcare costs. Unlike referrals between clinicians, specific data segmentation is appropriate to provide these programs relevant data they need without revealing unrelated patient information. The FHIR Bidirectional Services eReferral specification can be found here:

• http://hl7.org/fhir/us/bser/2018Sep/.

Proposed Track Lead

• Rick Geimer
• John Loonsk
• Arun Srinivasan

See Connectathon_Track_Lead_Responsibilities

Roles

Please include information here regarding how much advance preparation will be required if creating a client and/or server.

Scenarios

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