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Paving the Road to Use EHRs for Vital Records

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Paving the Road to Use EHRs for Vital Records

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    1. Paving the Road to Use EHRs for Vital Records NAPHSIS/NCHS Annual Meeting Hetty Khan June 7, 2010 Michelle Williamson Health Informatics Specialists National Center for Health Statistics Centers for Disease Control and Prevention

    2. Topics Overview of Electronic Health Records -EHRs eVital Records Standards Activities

    3. U.S. Plans for Health Information Technology

    4. U.S. Plans for Health Information Technology “To lower healthcare cost, cut medical errors, and improve care, we’ll computerize the nation’s health record in five years, saving billions of dollars in health care costs and countless lives.” ~~ President Barack Obama First Weekly Address January 24, 2009 Consistent with Bush’s 2014 goal for electronic health records

    5. U.S. Plans for Health Information Technology (HIT) American Recovery & Reinvestment Act (ARRA) is stimulating adoption of HIT Feb. 17, 2009: President Obama signed ARRA December 30, 2009: Office of the National Coordinator (ONC) issued an Interim Final Rule (IFR) on an initial set of HIT standards, implementation specifications, and certification criteria to promote adoption and “meaningful use” o f electronic health records criteria Centers for Medicare and Medicaid Services (CMS) announced a notice of proposed rulemaking (NPRM) to implement provisions of the Recovery Act that provide incentive payments for the meaningful use of certified EHR technology 

    6. U.S. Plans for Health Information Technology Towards a Definition of Meaningful Use: http://healthit.hhs.gov/ Health IT Policy Council Recommendations to National Coordinator on Meaningful Use Objectives and Measures HIT Standards Committee Meaningful Use Measures Data Elements Grid CMS criteria for demonstrating meaningful use: Stage 1: Data capturing Stage 2: Reporting health information and tracking key clinical conditions Stage 3: Improving performance and health outcomes http://www.cms.gov/Recovery/11_HealthIT.asp

    7. What is an EHR?

    8. What is an EHR? Benefits of EHRs Increase Accessibility Improve Quality Reduce Medical Errors Reduce Cost Reduce Duplicate Tests and Procedures Increase Sharing of Health Information in Emergency Situations Improve Continuity of Care Barriers to EHRs Adoption Cost Certification Security and Privacy Interoperability

    9. CDC/NCHS eVitals Standards Activities

    10. Standards to Support Capturing U.S. Vital Records Data at the Point of Care or Contact

    11. U.S. Vital Records Domain Analysis Model

    12. Birth Registration Activities Model

    13. Birth Core Data Model

    14. U.S. Vital Records Domain Analysis Model

    15. HL7 VR Functional Profile

    16. EHR-S Functional Model Standard The EHR-S FM presents a superset of functions for an EHR system from which a user/setting specific subset can be generated It lists all of the functions that an EHR-S SHALL, SHOULD or MAY perform Creates a common platform for providers, vendors, payers and others to describe needed EHR functionality

    17. HL7 EHR-S Functional Model This is what the FM looks like from the highest level.This is what the FM looks like from the highest level.

    18. Overview of the EHR-S FM Standard Layout of the FM: Functional Identification Number Functional Type (Header or function) Functional Name Functional Statement Functional Description “See also” column Conformance Criteria Layout of the FM: Functional Identification Number Functional Type (Header or function) Functional Name Functional Statement Functional Description “See also” column Conformance Criteria

    19. New VRFP Function

    20. Current Status of VRFP

    21. International VRFP Representatives from Australia, Brazil, Colombia, Korea, Japan and the UK attended a session during the last HL7 meeting and expressed an interest in collaborating to develop an International Vital Records Functional Profile that may serve as the foundation for international vital records data exchange. Specific countries can tailor the profile to suit their needs Representatives from Australia, Brazil, Colombia, Korea, Japan and the UK attended a session during the last HL7 meeting and expressed an interest in collaborating to develop an International Vital Records Functional Profile that may serve as the foundation for international vital records data exchange. Specific countries can tailor the profile to suit their needs

    22. Other eVitals Standards Activities EHR Cause of Death Work Group HITSP Maternal and Child Health Use Case IHE Maternal Child Health Profile

    23. EHR Cause of Death Work Group

    24. EHR Cause of Death Work Group Infobuttons” are context-specific links from one information system (usually a clinical information systems such as an electronic health record) to some other resource that provides information that might be relevant to the initial context. a customized link to a resource, intended to obtain topic-specific informationInfobuttons” are context-specific links from one information system (usually a clinical information systems such as an electronic health record) to some other resource that provides information that might be relevant to the initial context. a customized link to a resource, intended to obtain topic-specific information

    25. Healthcare Information Technology Standards Panel (HITSP) eVitals Related Activities ONC provided contractual support to HITSP to identify industry standards that would meet the needs of implementing specific use cases Maternal and Child Health Use Case Addresses the ability to exchange obstetric and pediatric patient information between EHRs, etc…….. Includes information exchanges for: Determination of pregnancy The birth event and incorporation of antepartum information Referrals and information flows to Vital Records NCHS provided input into the technical specifications developed by HITSP to assure consistency with the NCHS Edit Specifications for birth, death and fetal death RDSS 155 – Maternal and Child Health C170 – Vital Records Pre-Populate Component document http://www.hitsp.org/ The panel was formed in response to the ONC contract to enable and advance interoperability of healthcare applications, and the interchange of healthcare data. They developed Interoperability Specifications to address several ONC Use Cases One use case was the Maternal and Child Health Use Case which addresses the ability to exchange obstetric and pediatric patient information between EHRs, etc…….. NCHS has worked with HITSP to develop the C170 – which translates the requirements of vital records consistent with the NCHS Edit specifications for birth , death and fetal death into value statements that are testable in an electronic environment and identifies the path of exchange of specific data elements consistent with the position of DVS and NAPHSIS. The panel was formed in response to the ONC contract to enable and advance interoperability of healthcare applications, and the interchange of healthcare data. They developed Interoperability Specifications to address several ONC Use Cases One use case was the Maternal and Child Health Use Case which addresses the ability to exchange obstetric and pediatric patient information between EHRs, etc…….. NCHS has worked with HITSP to develop the C170 – which translates the requirements of vital records consistent with the NCHS Edit specifications for birth , death and fetal death into value statements that are testable in an electronic environment and identifies the path of exchange of specific data elements consistent with the position of DVS and NAPHSIS.

    26. Integrating the Healthcare Enterprise (IHE) eVitals Standards Activities IHE is an initiative by healthcare professionals and industry to promote the coordinated use of established standards to address specific clinical needs IHE Quality, Research, and Public Health Technical Committee developed a Mother and Child Health (MCH) profile which describes the data contents to be used in the automatic submission of the child and maternal health information to public health agencies Developed through input from France Modeled using the 2003 U.S. Standard Birth Certificate May 2010 – NCHS provided input on the MCH profile for consistency with the 2003 U.S. Birth Standard Specification

    27. Contact Information Michelle Williamson, RN, MSIS Senior Health Informatics Specialist CDC/National Center for Health Statistics Ph: 301-458-4618 Em: mwilliamson@cdc.gov Hetty Khan, RN, M.Sc Health Informatics Specialist CDC/National Center for Health Statistics Ph: 301-458-4311 Em: hdk1@cdc.gov

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