201809 Public Health

Public Health (Case Reporting, Registries, and Referrals)

DRAFT for proposal review

Submitting WG/Project/Implementer Group

Public Health (PH)

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 can differ, but frequently share a number of common design elements as well. This track will build on the previous public health electronic case reporting (eCR) track to provide a home and critical mass for these use cases as they develop and grow.

Electronic case reporting (eCR) has existing CDA product family standards, had a FHIR "for comment" ballot in January of 2018, and now has a September FHIR STU ballot. This use case will focus on the FHIR subscription dissemination of public health reporting trigger codes in a PlanDefinition construct and also establish 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: XXXXXX

Public health registry reporting shares numerous design elements with eCR. These elements include knowledge distribution 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. The Coverdell stroke registry and others are exploring approaches to implementation that support needed program outcomes from clinical workflow and data and leverage commonalities with other public health reporting.

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: XXXXXX

Proposed Track Lead

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

Scenario Step 1 Name

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