201801 Electronic Case Reporting
Electronic Case Reporting
Submitting WG/Project/Implementer Group
Public Health (PH)
Justification
Electronic case reporting has been maturing in the CDA product family with two documents, the electronic Initial Case Report (eICR) and the Reportability Response. 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 from Public Health to clinical care sites and EHRs;
- FHIR versions of the electronic Initial Case Report (eICR) and Reportability Response instance exchange;
- Eventual expansion to decision support logic and other transactions to support case reporting and management as those aspects mature in future Connectathons.
This track will include discussions on additional resource needs for these use cases as well. 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
Please include information here regarding how much advance preparation will be required if creating a client and/or server.
Public Health
Responsible for managing and disseminating trigger codes and decision logic.
Public Health Agency
Jurisdiction or agency that will receive and manage case reports, 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 HIEs, the shared platform supported by APHL and CSTE, etc.
Health Care Organization
Organization that submits case reports based on trigger codes, 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 and sending it to a Reportability Response 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 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.
- Precondition: Patient and Encounter resources exist, and sufficient clinical information to populate an eICR.
- Success Criteria: eICR is successfully posted to a FHIR server and validates against the eICR 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.
Receive eICR Document
- Action: eICR Document Creator prepares an initial case report and POSTs it to a FHIR server. The eICR Document Consumer does a GET on the eICR and processes it. (The POST and GET here may not be the only supported transactions, but they will be the initial ones that are tested)
- 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.
Create Reportability Response
- Action: Reportability Response Creator prepares a reportability response and POSTs it to a FHIR server.
- 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: Reportabilty Response Creator prepares reportability response and POSTs it to a FHIR server. The Reportabilty Response Consumer does a GET on the RR and processes it. (The POST and GET here may not be the only supported transactions, but they will be the initial ones that are tested)
- 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