HL7 Child Health Work Group Update HL7 EHR-Public Health Task Force Andy Spooner, MD CMIO, Cincinnati Children’s Hospital & Medical Center Co Chair, HL7.
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HL7 Child Health Work Group Update
HL7 EHR-Public Health Task Force
Andy Spooner, MDCMIO, Cincinnati Children’s Hospital & Medical
CenterCo Chair, HL7 Child Health Work Group
October 27, 2010
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Introductions & Purpose
Andy Spooner, MD, FAAPCMIO, Cincinnati Children’s Hospital & Medical CenterFounding Co Chair, HL7 Child Health Work GroupCo Chair, CCHIT Inpatient Work Group
Purpose1.Provide insight into related work products2.Explore next steps in potential collaboration
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Data Standards and Certification Criteria:EHR System Functionality for Child Health
Care1. Child Health Work Group Overview2. HL7 EHR-S Functional Model, Release 23. HL7 Child Health Functional Profile, Release
24. CCHIT Child Health Certification Criteria5. Gap Analysis Work 6. What’s Next7. Q&A
Session Overview
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Overview
HL7 Child Health Work Group
Founded: 2003Leadership: David Classen, MD, Gay Giannone, RN,
Andy Spooner, MD and Feliciano Yu, MDParticipation: Primarily CMIOs, physicians, medical
informatics experts and vendor representatives
Distribution: 100+ previously on emailOperations: One in person meeting and two webcast
meetings in conjunction with HL7 work group meetings; Other calls and webcasts as needed
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Emphasis To-Date
Functional Data Standards Standards for EHR systems include critical child health functions Published EHR system standards for general pediatrics Work was baseline for CCHIT child health certification criteria, other
Terminology Data Standards Explored improving terminology systems for pediatrics using AAP policy
statements (e.g. SNOMED) Funding not available to support further work
Messaging Data Standards Created immunization activity diagrams and story boards – now part of HL7
messaging standards Provided incubation and leadership in HL7 to develop standard for reporting
quality measure data – Quality Reporting Document Architecture using HL7 CDA
Provided support to create standards-based neonatal care report using HL7 CDA
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Functional Standards: Relationships of Artifacts
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Child Health Functional Profile History
Content drawn from AAP articles on important EHR functionality for child health care
Volunteers drafted functional requirements Requirements not included in the functional model became
material for the profile 25 volunteers contributed; Core team of 7 did the heavy
lifting Submitted intent to ballot form October 2007 Available for adoption as accepted HL7 and ANSI standard
– January 2009
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Manage Immunization Administration
Statement: Capture and maintain discrete data concerning immunizations given to a patient including date administered, type, manufacturer, lot number, and any allergic or adverse reactions. Facilitate the interaction with an immunization registry to allow maintenance of a patient’s immunization history.
Description: During an encounter, recommendations based on accepted immunization schedules are presented to the provider. Allergen and adverse reaction histories are checked prior to giving the immunization. If an immunization is administered, discrete data elements associated with the immunization including date, type, manufacturer and lot number are recorded. Any new adverse or allergic reactions are noted. If required, a report is made to the public health immunization registry.
1. The system SHALL provide the ability to recommend required immunizations, and when they are due, during an encounter based on widely accepted immunization schedules.
2. The system SHALL provide the ability to recommend required immunizations based on patient risk factors.
3. The system SHALL perform checking for potential adverse or allergic reactions for all immunizations when they are about to be given.
4. The system SHALL provide the ability to capture immunization administration details, including date, type, lot number and manufacturer.
5. The system SHALL provide the ability to capture other clinical data pertinent to the immunization administration (e.g. vital signs, adverse reactions).
6. The system SHALL record as discrete data elements data associated with any immunization.
7. The system SHOULD provide the ability to associate standard codes with discrete data elements associated with an immunization.
8. The system SHALL provide the ability to update the immunization schedule.
Function: “Manage
Immunization Administration”
“Capture and maintain discrete data concerning
immunizations…” Edits in RED for CH
Profile
Criteria requested by
Child Health for original model now standard
Example Edits and Additions to EHR
FM
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Results
Useful to CCHIT Child Health Work Group Will be useful for Model EMR Format for Children
Project Specific adoption/influence unknown other than
tie to CCHIT certified vendors for child health
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
AAP HL7 Child Health HL7 CCHIT
Published EMR
Position Papers
Developed
Pediatric EMR
Functions
Published Pediatric
EMR Functiona
l Model Standard
Influenced EMR
Vendor Certification Criteria
Vendor Compliance & Certification;
Provider Adoption
An Example
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
Gap Analysis Project
Compared: HL7 Child Health Functional Profile for EHR Systems CCHIT inpatient certification criteria, 2007 CCHIT ambulatory certification criteria, 2007 CCHIT child health certification criteria, 2007
Then: Submitted recommendations to CCHIT Child Health
WG, Feb. 2009; Letters and discussions with Inpatient and Ambulatory
WG completed review, May 2009; Will incorporate results into work on release 2 of the HL7 profile
www.hl7.org | HL7 Child Health Work Group | October 27, 2010
What’s Next
1. Input into EHR FM R22. Child Health Profile R23. Derived Profile for Neonatology
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