IHE QRPH Maternal and Child Health IHE Webinar Series Lori Fourquet e-HealthSign LLC
Dec 28, 2015
IHE QRPHMaternal and Child Health
IHE Webinar SeriesLori Fourquet e-HealthSign LLC
Maternal and Child Health Content
• Health at Birth Summary (HBS) content profile containing a summary of all the information impacting on the newborn’s health status evaluation as presented in the birth certificate.
• Child Growth Summary (CGS) content profile representing information about the child’s development (medical and social conditions) that can be submitted to health authorities for possible intervention or general epidemiological studies.
Maternal and Child Health Profile
• Value Proposition– Allow for communications of vital records through
electronic EHR sources:• Birth Certificate• Fetal Death Certificate• Health Certificate at Birth• Health Certificate at Nine Months• Health Certificate at Two Years
– Minimize duplicate data entry– Improve efficiency and accuracy
US Extension
• Use Retrieve Form For Data Capture• Provides specific mapping to US Vital Records
Forms and Data Elements• Provides Value sets supporting the mapping
IT Infrastructure Components Supporting Public Health
• Cross-Enterprise Document Sharing (XDS)• Cross-Enterprise Document Reliable Interchange (XDR)• Cross-Enterprise Document Media Interchange (XDM)• Patient Identifier Cross Reference Manager (PIX)• Patient Demographics Supplier (PDQ) • Pediatric Demographics Option (PDO)• Retrieve Form for Data Capture (RFD)• Audit Record Repository (ATNA)• Time Server (CT)• Personnel White Pages (PWP)• Cross-Enterprise User Assertion (XUA)• Cross Community Access (XCA)• Basic Patient Privacy Consents (BPPC)• Cross-enterprise Sharing of Scanned Documents (XDS-SD)• Document Digital Signature (DSG)• Enhanced Sharing Value Sets (ESVS)• Document Metadata Subscription (DSUB)• Multi-Patient Queries (MPQ)
• Sharing Value Sets • Addresses synchronization of content terminologies across applications• Key to semantic interoperability for quality, research and public health
analysis.• Supports communication of value set groups supporting specific functions
(e.g. Value Sets associated with Vital Records data pre-population
• Retrieve Form for Data Capture• Supports integration of form-based data capture directly within the EHR• Supports communication of Routine EHR-generated HL7 CDA Structured
Clinical Documents to enable pre-population of form data delivered to the user via the EHR interface
• XDS/XDM/XDR• Supports communication of CDA document with Vital Records Content
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MCH Infrastructure Profiles Supporting Public Health
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Vital Records Birth and Fetal Death Data Capture
Form Filler
Form Manager
Retrieve Form [ITI-34] along with pre-population data
Continuity of Care Document (CCD)
Form
Delivery of Form along with pre-population data bound to the form
Labor & Delivery Document
LDR + DE Birth/FD MessageXSLT
Reference ImplementationForm Manager
Form Receiver
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PCC ProfilesMedical Summaries
Emergency Department
Referral
ExchangingPHR
Content
AntepartumCare
Summary
EmergencyDepartmentEncounter Summary
FunctionalStatus
Assessments
2005-062005-062006-072006-072007-082007-082008-09 2008-09 2009-102009-10
Int
egra
tion
Cont
ent
Query for Existing Data
AntepartumRecord
ImmunizationRegistryContent
Care ManagementRequest for
Clinical Guidance
Labor and Delivery Record
Patient Plan of Care
EMS Transfer of
Care
Antepartum Record ScopeElectronically share data related to antepartum care between systems found in settings such as:
• Ambulatory offices• Specialists offices• Hospitals/birthing facilities
Antepartum Record Profile Abstract• APR is a folder of content profiles that contains the record
of antepartum care including:
• Antepartum History and Physical• Antepartum Summary• Antepartum Laboratory• Antepartum Education
Labor and Delivery Record
• The LDR Profile provides information to the health care providers about the labor and delivery and the newborn in an in-patient setting
• Useful for – Transfers of care in the in-patient setting (OR or NICU)– Post-partum outpatient care– Pre-population of Birth/Fetal Death Certificate
(QRPH)
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Maternal Child Health• Content profile describes to automating data
capture in vital records such as the birth certificate or early childhood health certificates.
• Pre-populate certificate with data from the EHR• Submit certificate to interested organizations– Retrieve Form for Data Capture (RFD)– Uses transactions and content modules defined in
other IHE profiles to provide interoperable data exchange.
– Provides value sets supporting data mining of Labor and Delivery Documents for form pre-population
• Provides Specific Rules to pre-populate US Birth and Fetal Death Certificate forms from the IHE-PCC Labor and Delivery Document
• Detailed value sets are provided supporting this US-specific data mapping that may be utilized for multiple national extensions
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Maternal Child Health: US National Extension
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Maternal Child Health
MCH US National Extension: Pre-population Rules
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US Attri-bute code
Birth
FD
Form Data
Element
Definition Derivation Rule
MCH Code Value sets
APGAR5
Y N Apgar Score: 5 Minute
A systematic measure for evaluating the physical condition of the infant at specific intervals following birth. Enter the infant’s Apgar score at 5 minutes.
If (Result Type CONTAINS ValueSet (5 Min Apgar Score)), THEN “APGAR5” = (Result Value)
Newborn Delivery Information1.3.6.1.4.1.19376.1.5.3.1.1.21.2.4Coded ResultsResult Type 1.3.6.1.4.1.19376.1.5.3.1.3.28
MCH HBS 5 Min Apgar Score Value Set1.3.6.1.4.1.19376.1.7.3.1.1.13.8.12
Newborn Delivery Information1.3.6.1.4.1.19376.1.5.3.1.1.21.2.4Coded ResultsResult Value1.3.6.1.4.1.19376.1.5.3.1.3.28
MECS Y N Characteristics of labor and delivery: Meconium staining
Moderate or heavy meconium staining of the amniotic fluid Staining of the amniotic fluid caused by passage of fetal bowel contents during labor and/or at delivery that is more than enough to cause a greenish color change of an otherwise clear fluid. Information about the course of labor and delivery.
IF (Problem Code CONTAINS ValueSet (MCH HBS Meconium staining Value Set) THEN “MECS” SHALL = “Y” LSE “N”E
Labor and Delivery1.3.6.1.4.1.19376.1.5.3.1.1.21.2.3 Active ProblemsProblem Code 1.3.6.1.4.1.19376.1.5.3.1.3.6
MCH HBS Meconium staining Value Set1.3.6.1.4.1.19376.1.7.3.1.1.13.8.36
Potential Demonstration Scenario
Scene Description Profiles/ Constructs
PCP Mother is seen by OB/GYN for care during Pregnancy Antepartum Record, XDS,
Hospital of Birth
Mother delivers child. Labor and Delivery Report is generated and used to pre-populate the Birth Certificate Request.
LDR, RFD
Public Health (VR)
The Birth Certificate is Received by Public Health Vital Records. Form Manager is reviewed including interface with CDC hosted Value Sets supporting the pre-population. Data is sent routinely to CDC over the NHIN
RFD, ESVS, LDR, NHIN Connect
CDC CDC receives routine birth certificate information from all states. Statistic for US Births are conducted to monitor the health status of the population.
NHIN Connect
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Questions?
Lori [email protected]