Early Hearing Detection and Intervention CDC – EHDI Program October 9, 2013

1. Brief Profile Proposal for 2013/14presented to theQuality, Research & Public Health (QRPH) Planning Committee Early Hearing Detection and Intervention CDC – EHDI Program October 9, 2013

2. The Problem In the United States, there are mandatory state-level programs, which operate based on jurisdiction-specific regulations, to address hearing care for young children. Under the Centers for Disease Control (CDC), these programs are referred to as the State Early Hearing Detection and Intervention (EHDI) Programs. Interoperability standards are needed to facilitate electronic exchange of information to support and monitor the quality of these EHDI programs.

3. Value Proposition Improve the efficiency and effectiveness of information exchange to: Make is easier to communicate accurate, comprehensive hearing screening information for every child Increase capabilities to detect and plan intervention for children who have not received hearing screening Improve care for children with or at risk for hearing problems Improve care coordination and care planning for children with hearing problems Reduce reporting burden on care providers and state agencies Leverage evidence-based care guidance to continually improve quality of care for children across all EHDI programs

4. Market Readiness Several state EHDI programs have been participating in Pilot projects to gain experience with IHE profiles supporting EHDI Additional states are monitoring developments and using the Pilots to gain implementation knowledge Oz Systems continues to be a market leader in implementing standards which support EHDI programs Several other EHR and PH-IS vendors have been involved through support of the EHDI profiles

5. Existing IHE Profiles and Risks Development of the Result Report and Screening Outcome Report are required to complete specifications needed by the EHDI-WD profile. Additional CPs are needed to maintain alignment across the profiles needed to support EHDI information exchange across the many stakeholders involved.

6. Use Case Proposed Use Case (Not New – just more specific) A device is used to perform hearing tests on newborns. The device (through an internal or external communication mechanism) sends to the Computing Entity the result using HL7 v2 message format each time a test on a particular ear (right or left) is performed, one result message per test. Each instance of result information is preserved as a CDA Document. A system aggregates the result messages and generates the CDA document for the overall testing result outcome. The hearing screening outcome test is sent to a Receiving System (an EHR, an intermediary system or the Public Health Information System (PH-IS) and is incorporated into a Hearing Care Plan CDA document which aligns with the vision for creating larger Patient-centered Care Plan documents.

7. Use Case Proposed Content Profiles

8. Proposed Standards & Systems IHE IHE PCC EHDI-WD PCC Care Plan Content Profile, PCC Order and Referral Linking; QRPH NANI Profile IHE Lab Report HL7 HL7 C-CDA v2.0 Care Plan Document HL7 Newborn Hearing Screening Message (PCD01) HL7 QRDA, e-Measure for EHDI 1a Vocabulary Standards Vocabulary and value sets defined for EHCP and the new HL7 Hearing Screening Message

9. Discussion What level of effort do you foresee in developing this profile? Major Slot: 2 Content Profiles (1 section each, detailed entry) Major CP slot: Updates to EHCP Major CP slot: Updates to QME-EH (if funded) Profile Editor: Lisa Nelson, Jim Jellison