201801 Electronic Case Reporting

Return to Jan 2018 Proposals

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