Agenda

1. Public Health Reporting InitiativeStage 3 Sprint: Implementation Guide DevelopmentPhone: 800-857-9362 x93830 1

2. Agenda • New Member Introductions • Implementation Guide Development: Project Plan • Implementation Guide Table of Contents • Next Steps • Additional Questions?

3. Suggested Ground Rules • Everyone may speak • ID your name & user story (report type) • Listen carefully • Read assigned work and minutes before each meeting • Limit “back-pedalling” to critical issues • Yield when it is “good enough”- do not let perfection threaten good • Seek consensus quickly; let moderator test consensus • If consensus fails, Tier 2 steps back to see if consensus can procede for this first version of the specification • Concerns about process? Immediately bring to Foldy’s attention • 678-733-4289 • skf6@cdc.gov

4. Implementation Guide Development • Goal: Develop implementation guidance for the common core data elements using both 2.x and CDA in parallel • Sequential approach to finalizing common core data elements and reviewing implementation guidance • ToCand process: 8/30 meeting • 1st set of data elements: 9/6 meeting • 2nd set of data elements: 9/13 meeting • 3rd set of data elements: 9/20 meeting • Outstanding issues & finalization: 9/27 meeting • Final draft review: 10/4 meeting

5. Implementation Guide ToC • Developed two preliminary tables of content to outline what is included in a 2.x guide and what is included in a CDA guide • As the implementation guidance is written and reviewed, the table of contents may change to accommodate discussions/requirements out of the sprint group • The Public Health Reporting Implementation guide will draw from existing implementation guidance for public health reporting (e.g., Cancer, Immunization, etc.)

6. ToC-CDA • 1.Introduction 6 • 1.1.Purpose 6 • 1.2.Audience 6 • 1.2.1.Requisite Knowledge 6 • 1.3.Scope 6 • 1.4.Summary of Key Technical Decisions 6 • 1.4.1.PHRI User Story Development 6 • 1.4.2.Data Harmonization Profile - Approach to Core Common and Extended 6 • 1.4.3.Use of CDA Document Standards 6 • 1.4.4.Conformance to this Guide 6 • 1.5.Sequence Diagram 7 • 1.6.Actors and Roles 7 • 1.7.Key Technical Decisions 7 • 1.7.1.Data Harmonization Profile Overview 7 • 1.7.2.Exchange Specification 7 • 1.7.3.Conformance to this Guide 7 • 1.8.Organization of this Guide 7 • 1.8.1.Conventions Used in this Implementation Guide 7 • 1.8.2.Element Attributes 7 • 1.8.3.Key Words 8 • 2.Document Specifications 8 • 2.1.Header 8 • 3.Section Specifications 8 • 3.1.Allergy 8 • 3.2.Diagnosis 8 • 3.3.Employer Information 8 • 3.4.Encounter 8 • 3.5.Facility 8 • 3.6.Immunization (Vaccination) 8 • 3.7.Medication 8 • 3.8.Order 8 • 3.9.Patient Contact Information 9 • 3.10.Patient Information 9 • 3.11.Procedure 9 • 3.12.Provider Information 9 • 3.13.Report 9 • 3.14.Result 9 • 3.15.Social History 9 • 3.16.Specimen 9 • 3.17.Vital Sign Indicators 9 • 4.Field Level Implementation Specification 9 • 5.Additional Implementation Guidance 9 • Appendix A: Reference Documents 10 • Appendix B: Definitions and Acronyms 11 • Appendix C: Summary of Data Element Optionality 12 • 5.1.Data Element Optionality 12 • 5.1.1.Examples of NULL Flavors 12 • 5.2.Entity Optionality 12 • Appendix D: Recommended Value Sets and Vocabulary Summary 13

7. ToC 2x • 1.Introduction 6 • 1.1.Purpose 6 • 1.2.Audience 6 • 1.2.1.Requisite Knowledge 7 • 1.3.Scope 7 • 1.4.Summary of Key Technical Decisions 7 • 1.4.1.PHRI User Story Development 7 • 1.4.2.Data Harmonization Profile - Approach to Core Common and Extended 7 • 1.4.3.Use of HL7 2.x Messaging Standards 7 • 1.4.4.Conformance to this Guide 7 • 1.5.Organization of this Guide 7 • 1.5.1.Conventions Used in this Implementation Guide 7 • 1.5.2.Key Words 8 • 2.Public Health Reporting Specification – HL7 Segments 8 • 2.1.Adverse Event 9 • 2.2.Allergy 9 • 2.3.Diagnosis 9 • 2.4.Employer Information 9 • 2.5.Encounter 9 • 2.6.Facility 9 • 2.7.Family History 9 • 2.8.Immunization 9 • 2.9.Medication 10 • 2.10.Order 10 • 2.11.Patient Contact Information 10 • 2.12.Patient Information 10 • 2.13.Procedure 10 • 2.14.Provider Information 10 • 2.15.Result 10 • 2.16.Social History 10 • 2.17.Specimen 10 • 2.18.Vital Sign Indicators 10 • 3.Public Health Reporting Specification – HL7 Data Fields 10 • 4.Defining the HL7 MSH Segment 11 • 5.Public Health Reporting Specifications – HL7 2.x Messaging 11 • 5.1.Example – Public Health Core Report 11 • 6.Public Health Reporting Development Resources 12 • 7.Additional Implementation Guidance 12 • Appendix A: Reference Documents 13 • Appendix B: Requirements Traceability Matrix 13 • Appendix B: Definitions and Acronyms 14 • Appendix C: Summary of Data Element Conformance 15 • 7.1.Optionality 15 • 7.1.1.Examples of NULL Flavors 15 • Appendix D: Recommended Value Sets and Vocabulary Summary 16 • 8.IG Compliance Matrix – Internal Only 16

8. Example Purpose (2.x guide) • The purpose and value of this implementation guide document for the PHRI initiative. In the purpose section, it will be important to note why we are taking the technical approach that was taken in PHRI in relation to defining the core common, and why we will be creating implementation guides for both CDA and HL7 2.x messaging. • The Public Health Reporting Specification – HL7 2.x Messaging is designed to provide a catalog of segments to be used in generating public health reports, as a series of messaging profiles for use by public health stakeholders. • This approach supports multiple objectives: • Maintenance: Any subsequent change to any segments or fields that are used in public health reports will be made in a single source which then gets republished and made available to the public health community • Translation: This specification can the natural home for mapping tables from key public health reporting data elements (the core common) - the mapping tables would be built into the structure of the message • Familiarity: those familiar with either this guide or the CDA guide can, by contact, become familiar with the other, lessening the stress of decisions on which way to go. • Issues of incompatibility can be addressed in one location, so that all public health reports using HL7 2.x messaging standards can draw from a single source of changes

9. Questions to Consider • As you review sections of the Implementation Guide, keep in mind: • “Does the implementation format chosen make sense? I.e. When we describe what a procedures section will look like in a public health report, is it usable to an implementer?” • As we move towards elaborating report type specifications, which report types can work towards 2.x and CDA guides? • Leveraging the common core and then developing report type specific data elements to create implementation guidance

10. Questions / Discussion? • Wiki Page • http://wiki.siframework.org/PHRI+Implementation+Guide • Or click “Implementation Guide” button from any PHRI wiki page • Will post presentations, meeting minutes, “homework”, and documents for review • Additional Questions? Contact Lindsay Brown (lrbrown@cdc.gov) 10