Public Health Data Standards Consortium phdatastandards

1. Public Health Data Standards Consortium http://phdatastandards.info

2. 2nd Connecting Communities for Better Health Learning ForumMay 25-26, 2005, Washington DCTechnical Aspects Track Developing an Incremental Pathway Towards Interoperability and Health Information Exchange Anna O. Orlova, PhD Executive Director, PHDSC and Johns Hopkins Bloomberg School of Public Health

3. Clinical Anthrax Dx Asthma treatment Immunization administration Blood lead level Diabetes with ketoacidosis (250.1) (in patient) Public Health Anthrax epidemic Asthma surveillance Immunization stock pile Level of lead exposure Diabetes with ketoacidosis (250.1) (in population) Q1. Special considerations of semantic interoperability for public health Clinical versus Public Health Concepts Based on Steven Steindel’s Presentation “Perspectives on the Developing Public Health Vocabulary, Data Standards and Models.” AMIA, November 2004, Washington DC

4. Q1. Special considerations of semantic interoperability for public health FROM… • No Standards for sharing of health information between PH programs • Multiple approaches to PH data gathering • Ability only communicate to one PH program at a time TO… • Standards in architecture allow data sharing/transfer • Common approach to PH data gathering • Communicate to PH data from outside sources • To provide access to PH data for providers • To coordinate clinical care and PH practices in serving the public’s health Based on Steven Steindel’s Presentation. AMIA, November 2004, Washington DC

5. Q1. Special considerations of semantic interoperability for public health Semantic interoperability in the past is categorization Semantic interoperability in the future is commitment to adhere to all of the standards encompassed in RHIE and global NHIN specification requirements

6. Q2. Specific solutions from public health that could be adopted by other HIE implementers Public Health Experience with Data Integration State Health Systems • Missouri • Utah • Rhode Island • New York State

7. Missouri Health Strategic Architectures and Information Cooperative Project (MOHSAIC) Statewide Network or Web Access Real-time Link Data Merge BIRTHS: Birth Loads, Name, DOB, Sex, Race, DCN HEALTH MANAGEMENT & REGULATED Other Birth Info Medicaid Encounters SURVEILLANCE INTEGRATED INTEGRATED DATABASE DATABASE Registration, Demographics, Scheduling, Inventory Immunization TB Family Planning Service Coordination EPSOT/DCY Traumatic Brain Injury Eligibility TL-Link Lead Family Care Safety Registry Bureau of Narcotics & Dangerous Drugs Lead Inspection & Abatement Child Care Licensing Accredited Training Registry Communicable Disease HIV/AIDS STD TB DEPT. OF SOCIAL SERVICES DCN, Medicaid Enrollment, Aging EDL, Managed Care Info, FAMIS NEOMETRICS: Metabolic & Newborn Hearing Results Audiological Assessment Private Physician Records Private Physician Records WIC Highway Patrol Laboratories Ellen Wild, etal. 2004. Key Elements for Successful Integrated Health Information Systems. JPHMP,.S36-47

8. Utah’ Child Health Advanced Records Management System (CHARM) PHASE I PHASE II Web Access Charm Agents Charm Agents Children With Special Health Care Needs Birth Registration Date Ware House Newborn Metabolic Screening Birth Defects CHARM SERVER Security Manager Data Catalog Child Registration Matcher & Merger Query Monitor Statistics Manager Newborn Hearing Screening Lead Screening Women Infants Children Early Intervention Utah Statewide Immunization Info System Neonatal Follow-up PHASE III Child Health Insurance Program CNEC EPSOT System DHS-DCPS Foster Care Medicaid Ellen Wild, etal. 2004. Key Elements for Successful Integrated Health Information Systems. JPHMP,.S36-47

9. MSDS VRS Draw Blood Sample Blood Spot Card CMS Vital Records Mailer Birth Certificate HIS WAARP Firewall Hospital Data Entry Mailer FAX New York State Integrated Clinical Management System (ICMS) Hospital DOH B Exception Reports C A WebServer Follow-up INTERNET Physician or Case Manager A. Establish link to EBC records B. Report missing or late blood spot cards C C. Allow mailer image viewing through browser Source: Perry Smith. 2nd Connecting Communities for Better Health Learning Forum, May 25-26, 2005, Washington DC

10. Rhode Island’s KIDSNET  RHIO • Newborn Metabolic Screening Registry • Newborn Hearing Screening Registry • Birth Defect Registry • Immunization Registry • Birth Registration

11. PHDSC EHR-PH System Prototype for Interoperability of Clinical and Public Health Systems, HIMSS-2005 Clinical Care Public Health Hospital of Birth State Health Department ADT- Birth Record Newborn Screening Registry HL7 2.4 HL7 3.0 EHR-PH Info Exchange Newborn Screening Test HL7 3.0 HL7 3.0 Hearing Screening Registry HL7 3.0 HL7 2.4 Hearing Screening Test HL7 2.4 Immunization Registry J2EE HL7 2.4 Immunization Administration Communicable Disease Registry External Laboratory Source: Orlova, et al. HIMSS 2005,Dallas TX, February 13-17, 2005

12. PHDSC EHR-PH System Prototype for Interoperability of Clinical and Public Health System Our Prototype • Illustrates how interoperability between clinical and public health systems can be achieved with a standards-based infrastructure • Is built upon existing systems in clinical care and public health programs • Enables electronic data reporting from a clinical setting to multiple public health systems • Enables translation of customized standards into HL7 3.0 messaging standard • Links clinical and public health systems to provide a continues view of the patient record across the systems involved

13. Q3. Key principles and lessons learned that could be applied elsewhere • Define the goal: • The goal is not to build the data exchanges • The goal is to provide information for comprehensive and coordinated care via data exchange • Understand work processes of stakeholders and how they will be affected by data exchanges that will emerge • Define how to involve stakeholders • To be informed is not enough • Involve them in the development and implementation not just develop for them