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CDC Message Development Using HL7 Version 3 Principles

CDC Message Development Using HL7 Version 3 Principles. Mead Walker. January 8, 2002. Presentation Outline. Introduce CDC Projects Using national standards HL7 in particular Review progress so far Consider impacts on V3 development What about impacts on other government work?.

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CDC Message Development Using HL7 Version 3 Principles

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  1. CDC Message Development Using HL7 Version 3 Principles Mead Walker January 8, 2002

  2. Presentation Outline • Introduce CDC Projects • Using national standardsHL7 in particular • Review progress so far • Consider impacts on V3 development • What about impacts on other government work?

  3. Messaging Projects • Notificationmanaging notificable disease reports • Vital StatisticsBirth and Death information • Anti-Microbial ResistanceReporting on antibiotic susceptibility and pharmacy drug use The context for these projects is providedby something called“NEDSS” CDC Version 3 Messaging

  4. A Vision for National Electronic Disease Surveillance System (NEDSS) • Gathers health data automatically from a variety of sources on a real-time basis • Monitors the health of communities • Assists in ongoing analyses of trends and detection of emerging public health problems • Provides information for setting public health policies • Is a system of interoperable systems like the Internet is a network of interoperable networks – is not a software program CDC Version 3 Messaging

  5. NEDSS “at-a-glance” • NEDSS is a broad initiative using national data and information system standards for development of efficient, integrated, and interoperable surveillance systems at the state and local levels • Data standards—Conceptual data model, http://www.cdc.gov/cic • Harmonizing with HL7 Reference Information Model • NEDSS System Architecture http://www.cdc.gov/cic • Includes tools for electronic data transfer to health department from health care system: • Eg from multi-jurisdictional clinical labs • Architecture built on Integrated Data Repository; data from health care to health department sent via • single “pipeline”: single format, receiving point, security • Security standards (HIPAA compliant) to maintain public health track record in protecting sensitive data • Starts with focus—infectious disease—but keeps big picture in mind CDC Version 3 Messaging

  6. “Standards and Derived Specifications” • National Standards • “true” standards • needed for sharing • “conceptual” • not specific enough • Design Specifications • standards? • “physical” • risk of proprietary nature • need national underpinning CDC Version 3 Messaging

  7. “Standards and Derived Specifications” • National Standards • “true” standards • needed for sharing • “conceptual” • not specific enough • Use national standards wherever possible • Use and publish “design specifications” in order to do the work • Have a very high bar to change vs. derive • Be prepared to follow the refinement of standards • Design Specifications • standards? • “physical” • risk of proprietary nature • need national underpinning CDC Version 3 Messaging

  8. “Standards and Derived Specifications” • National Standards • “true” standards • needed for sharing • “conceptual” • not specific enough • See that public health issues are represented in national standards • Document specification development activities • Use opportunities to promote the sometimes more difficult approach of using standards • Design • Specifications • standards? • “physical” • risk of proprietary nature • need national underpinning CDC Version 3 Messaging

  9. A Philosophy for CDC Messaging Projects • Develop HL7 Version 3 messages. • Use the RIM and the Message Development Framework. • Use HL7 vocabulary domains • Create a consistent set of work products across the projects. • Influence HL7 • Suggest RIM changes and vocabulary items • Plan to submit message formats for standardization • Work within the technical architecture developed by NEDSS CDC Version 3 Messaging

  10. Using the MDF - CDC Style • Document messaging requirements • Map relevant data to the RIM. Use data mapping as a source for the RMIM. (These two can be documented together with simple source data.) • HL7 tooling supports definition of HMDs, message types, and XML schemas. • Create mappings between message elements and source and target databases • Address vocabulary issues by looking at HL7 domains first, but not last. CDC Version 3 Messaging

  11. Current CDC Projects • Notification Messaging • Communicate notifiable disease reports from states to CDC. • This is a core component of the NEDSS Base System. • Vital Statistics • Provide a specification for Birth and Death information. • There is also a need to support “verification/certification”. • Antimicrobial Use Reporting • Periodic (monthly) reporting of antibiotics use and organism susceptibility from providers to CDC. • This is expected to be expanded to support reporting on individual isolates. CDC Version 3 Messaging

  12. Messaging Analysis • Statement of RequirementsWe did not do formal use case analysis. This would be important for a “new” area. • Messaging ScenariosThis documents needs for communication, and the discussion around those needs. • Interaction DiagramA record of the interactions to be supported • Interaction GridDocuments Trigger events, and message dependencies. CDC Version 3 Messaging

  13. Notification Messaging Scenarios • Condition NotificationState or other reporting base system sends a notification to CDC. CDC will acknowledge receipt. A negative acknowledgement will be sent if the message that has been received cannot be processed. • Change/Retraction of Prior NotificationState or other reporting base system sends a notification update/change/retraction. This message will always provide a reference to the earlier notification that is being updated, changed, or retracted. CDC will acknowledge receipt. A negative acknowledgement will be sent if the message that has been received cannot be processed. • Summary NotificationState or other reporting base system provides total amounts for the reporting, during a specified time period, of a specific disease or condition to CDC. CDC will acknowledge receipt. A negative acknowledgement will be sent if the message that has been received cannot be processed. • Notification ResponseCDC will provide a response to the state or other reporting base system once the CDC base system has processed the message. This message will indicate that the message was successfully processed by the interface engine. The state or other reporting base system will acknowledge receipt. A negative acknowledgement will be sent if the message that has been received cannot be processed CDC Version 3 Messaging

  14. Interaction Specification CDC Version 3 Messaging

  15. Diagram Based Mapping • Can be constructed in a group session. • Becomes an education on the HL7 RIM. • Leads naturally into RMIM construction. CDC Version 3 Messaging

  16. Mapping from Source Data • The detailed tabular mapping: • Covers a wealth of data • Includes domain information • Allows room for comments. CDC Version 3 Messaging

  17. Notification RMIM (Rose UML model) CDC Version 3 Messaging

  18. Message Artifacts: HMD Fragment CDC Version 3 Messaging

  19. <?xml version="1.0" encoding="UTF-8" standalone="no"?> <!-- edited with XML Spy v4.1 U (http://www.xmlspy.com) by MeadWalker (Computer Sciences Corporation) --> <!-- This schema document has been automatically generated from NEDSSNTF_V1_001.xml by hmd2xsd.xsl, version 0.3. Other than the value of the default NS decl and any NS decls for CMETs, this schema document should NOT be hand edited; rather, the original HMD should be modified in RoseTree, serialized as XML and then this schema document should be regenerated. --> <xsd:schema targetNamespace="urn::hl7.org/NTF_V1_001.01" xmlns="urn::hl7.org/NTF_V1_001.01" xmlns:v3dt="urn::hl7.org/v3dt" xmlns:hl7="urn::hl7.org" xmlns:xsd="http://www.w3.org/2001/XMLSchema" elementFormDefault="qualified"> <xsd:annotation> <xsd:documentation/> <xsd:appinfo> <hl7:hmdName>Notification Report</hl7:hmdName> <hl7:hmdID>NEDSSNTF_V1_001</hl7:hmdID> <hl7:messageID>NTF_V1_001.01</hl7:messageID> <hl7:rmimID>NND 00.16.01</hl7:rmimID> </xsd:appinfo> </xsd:annotation> <!-- import the schemas for other namespaces, i.e., V3DT and any CMETs needed --> <xsd:import namespace="urn::hl7.org/v3dt" schemaLocation="v3dt.xsd"/> <xsd:import namespace="urn::hl7.org/IMCO_MC_MT00001" schemaLocation="IMCO_MC_MT00001.xsd"/> <xsd:element name="MI_Notfctn" type="NTF_V1_001.01"> <xsd:annotation> <xsd:appinfo> <hl7:rowType>Class</hl7:rowType> <hl7:METsource>N</hl7:METsource> <hl7:hmdClass>Message_interaction</hl7:hmdClass> <hl7:hmdProperty>MI_Notification</hl7:hmdProperty> <hl7:hmdRowID>NEDSSNTF_V1_001-NEDSSNTF_V1_001-MI_Notfctn-hmd</hl7:hmdRowID> </xsd:appinfo> </xsd:annotation> </xsd:element> Message Artifacts II: Schema Fragment • <?xml version="1.0" encoding="UTF-8" standalone="no"?> • <!-- edited with XML Spy v4.1 U (http://www.xmlspy.com) by MeadWalker (Computer Sciences Corporation) --> • <!-- • This schema document has been automatically generated • from NEDSSNTF_V1_001.xml by hmd2xsd.xsl, • version 0.3. • Other than the value of the default NS decl and any NS decls for • CMETs, this schema document should NOT be hand edited; rather, the • original HMD should be modified in RoseTree, serialized as XML and • then this schema document should be regenerated. • --> • <xsd:schema targetNamespace="urn::hl7.org/NTF_V1_001.01" xmlns="urn::hl7.org/NTF_V1_001.01" xmlns:v3dt="urn::hl7.org/v3dt" xmlns:hl7="urn::hl7.org" xmlns:xsd="http://www.w3.org/2001/XMLSchema" elementFormDefault="qualified"> • <xsd:annotation> • <xsd:documentation/> • <xsd:appinfo> • <hl7:hmdName>Notification Report</hl7:hmdName> • <hl7:hmdID>NEDSSNTF_V1_001</hl7:hmdID> • <hl7:messageID>NTF_V1_001.01</hl7:messageID> • <hl7:rmimID>NND 00.16.01</hl7:rmimID> • </xsd:appinfo> • </xsd:annotation> • <!-- • import the schemas for other namespaces, i.e., V3DT and any • CMETs needed • --> • <xsd:import namespace="urn::hl7.org/v3dt" schemaLocation="v3dt.xsd"/> • <xsd:import namespace="urn::hl7.org/IMCO_MC_MT00001" schemaLocation="IMCO_MC_MT00001.xsd"/> • <xsd:element name="MI_Notfctn" type="NTF_V1_001.01"> • <xsd:annotation> • <xsd:appinfo> • <hl7:rowType>Class</hl7:rowType> • <hl7:METsource>N</hl7:METsource> • <hl7:hmdClass>Message_interaction</hl7:hmdClass> • <hl7:hmdProperty>MI_Notification</hl7:hmdProperty> • <hl7:hmdRowID>NEDSSNTF_V1_001-NEDSSNTF_V1_001-MI_Notfctn-hmd</hl7:hmdRowID> • </xsd:appinfo> • </xsd:annotation> • </xsd:element> CDC Version 3 Messaging

  20. Lessons Learned and to be Worked on • The process for creating message specifications works • XML has wide credibility, and becomes a major selling point. However XML implementation skills are just developing. (Specifically the implementation of XML as a messaging format.) • The tooling to support schema creation is still evolving. • HL7 datatypes can provide a shock. This needs to be cushioned by agreed on methods for simplification. CDC Version 3 Messaging

  21. Item for Discussion • What about impacts on other government work? CDC Version 3 Messaging

  22. Any More Questions? Mead WalkerHealth Data & Interoperability Consulting T: 610-518-6259 F: 509-357-7983 E: mead@voicenet.com

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