Sending and Receiving Newborn Screening (NBS) Results in ... · Mirth is used to transform NBS messages from the normalized repository into individual HL7 messages for delivery to

Sending and Receiving Newborn Screening (NBS) Results in Indiana

Bob Bowman, MS, MA, MSDirector of Genomics and Newborn Screening

APIAPI

API

API

Morbid Obesity

VR Fetal Death

SAERS

VR Death Records

VR Birth Records

Newborn Screening

Newborn Hearing

Birth Defects

Core

The Application Program Interface (API): ISDH Repository API is a middle-tier object between the database and applications/data source. It enforces business rules and standards required by the ISDH Repository. It helps maintain data integrity, improve security and HIPAA standards, and reduce redundant code.

ISDH Repository

ISDH Repository

Event data is separated into application or source specific schemas allowing programs the flexibility to customize to their own unique needs.

The ISDH Repository “Core” stores identifiable/centric data for people and places. The Core maintains multiple versions of each data object. Original versions of data allow each program area to have their version of data which eliminates the possibility of another source overwriting their content.

Morbid Obesity

VR Fetal Death

Vital Records

ISDH -MCSHC

IU/Regenstrief

Cons

umer

s

SAERS

APIAPI

VR Death Records

VR Birth Records

Newborn Screening

Newborn Hearing

Birth Defects

Core

API

API

FSSA

Dat

a Pr

ovid

ers

Hospitals

Physicians

IOT

DM

Z -F

IRE

WA

LL

Internal / External Web Applications

ISDH Repository

ISDH Repository

ISDH Gateway Apps

MODE

Maternal Mortality

Acute Care

Birth Defects Registry

Cystic Fibrosis

Sickle Cell

EARS/EHDI

INSTEP

Person Search

SAERS

EHDI Alerts and Response System (EARS)

Indiana Newborn Screening Tracking and Education Program Application (INSTEP)

INSTEP

INSTEP

Pipe-Delimited Flat File

2010accession|K999999|1234MRN|SMITH|INFANT| … |Amino Acid Disorders|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Biotinidase Deficiency|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Cystic Fibrosis|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Endocrine Disorders|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Fatty Acid Disorders|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Galactosemia|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Hemoglobinopathy|||Normal| …2010accession|K999999|1234MRN|SMITH|INFANT| … |Organic Acid Disorders|||Normal| …

NBS Specimen Gate Lab Results

Accession number Requisition number Medical record number Infant's last name Infant's first name Sex Infant's race Infant's ethnicity Birth weight Birth order Date of birth Time of birth Type of sample Date the sample was drawn Time the sample was drawn

Doctor's zip code Doctor's phone number Date and time the mailer was printed Group Analyte Action Text Determination Normal range Hearing category Hearing date right Hearing date left Hearing result right Hearing result left Hearing risk factors Hearing not screened Previous Surname RCDisplayName

Date the sample was received Specimen quality code 1 Specimen quality code 2 Specimen quality code 3 Date of the first protein feed Time of the first protein feed Type of protein feed Whether or not the baby was premature Whether or not the baby was transfused Date the baby was transfused Gestational age Phlebotomist's code Previous accession number Mother's last name Mother's first name

Mother's date of birth Mother's street address Mother's city Mother's county Mother's state Mother's zip code Mother's phone number Submitting hospital code Birth hospital code Doctor's last name Doctor's first name Doctor's street address 1 Doctor's street address 2 Doctor's city Doctor's state

Includes the following data elements

NBS Specimen Gate Lab Results

ISDH Repository Loader

Processes results and person information through centralized Application Program Interface (API).

Data is matched, de-duplicated, and normalized into the ISDH Repository.

During Person Process the following keys are analyzedKeys 1 - 9 are reserved for special keys custom to the calling program area

Special Keys for Vital Records BirthKey 1: Last Name, Birth Certificate #Key 2: Date of Birth, NBS Requisition # (specimen gate)Key 3: Date of Birth, NBS Requisition # (birth)Key 4: Last Name, Date of Birth, Medical Record Number (birth)Key 5: Last Name, Date of Birth, Medical Record Number (specimen gate)

Special Keys for Newborn Screening- Specimen GateKey 1: Date of Birth, Time of Birth, NBS Requisition # Key 2: Date of Birth, NBS Requisition # (birth)Key 3: Date of Birth, NBS Requisition # (specimen gate)Key 4: Last Name, Accession NumberKey 5: Date of Birth, Accession NumberKey 6: Date of Birth, Time of Birth, Last NameKey 7: Date of Birth, Last Name, First NameKey 8: Date of Birth, Medical Record Number (specimen gate)Key 9: Date of Birth, Medical Record Number (birth)

Keys 10 - 25 are general matching keys for all non-”staged” records Key 10: SSN, First Name Initial, Last Name(6), Mothers Maiden..Key 11: SSN, First Name, Maiden Name.Key 12: SSN, Gender, Last NameKey 13: DOB, SSN, TOBKey 14: DOB, TOB, Birth Order, Last Name, First Name, Middle Name InitialKey 15: DOB, TOB, Birth Order, First Name, Mothers Maiden NameKey 16: DOB, First name, Last name, Maiden Name Key 17: DOB, First name, Last Name, Gender, Mothers maidenKey 18: DOB, TOB, Birth Order, Mothers MaidenKey 19: DOB, Last Name, BirthOrder, TOBKey 20: DOB, Last Name, First Name, Middle Key 21: DOB, Last Name, First Name, Middle Name InitialKey 22: DOB, Last Name (6/6), First Name, MiddleKey 23: DOB, Last Name, First Name, Middle Int (optional)Key 24: First, Last, DOB >> Security Code inKey 25: First, Last, DOB >> Integrated View

Search for

Matching Key

Person Process

Function

Update Person Records

Create New

Person

ISDH Repository

Person Matching Person Details

Found

Match

Did not

Find Match

Staged Person

Mirth is used to transform NBS messages from the normalized repository into individual HL7 messages for delivery to Regenstrief / ICEPHI then to providers.

Mirth Connect

Messages created to conform to IU / Regenstrief specification. Later releases will incorporate NLM specifications and standard vocabularies (LOINC, etc.)MSH|^~\&|RLY_NB|RILEY|NEWBORN|REGEN|20051202070251||ORU^R01|||2.3PID|||2999999^^^3999999999||CHILD^||200999999999|3|value|12||||||||||||0NK1||CHILD^|Mother|Here^^INDIANAPOLIS^IN^46222^^^^MARION|3179999999|||||||||||19999999PV1|||||||^ROGERS^FREDOBR|1|K999999^ISDHNB|20099999999^RLY_NB|556^NEW BORN SCREENING^L|||200906170420|||||||20090618|||||||||||||||K999999&ISDHNB^200999999999&RLY_NB|||||RMZLR|8111 TOWNSHIP LINE RD^SUITE 100^INDIANAPOLIS^IN^46260|^^032||3175155555OBX|1|NM|509^WEIGHT OF NEWBORN BABY^L||1300|gOBX|2|ST|550^BIRTH ORDER^L||OBX|3|NM|510^BIRTH HOSPITAL CODE^L||032OBX|4|CE|511^TYPE OF SAMPLE^L||533^REPEAT^ROBX|5|TS|512^DATE AND TIME OF FIRST PROTEIN FEED^L||200906130930OBX|6|CE|513^TYPE OF PROTEIN FEED^L||520^LACTOSE^ROBX|7|CE|514^WAS THE BABY PREMATURE?^L||525^YES^ROBX|8|CE|515^WAS THE BABY TRANSFUSED?^L||526^NO^ROBX|9|TS|554^DATE BABY TRANSFUSED^L||OBX|10|NM|516^GESTATION AGE^L||29|weeksOBX|11|TS|517^DATE AND TIME MAILER WAS PRINTED^L||20090622OBX|12|CE|79^NORMAL^L||526^NO^ROBX|13|CE|535^HEARING NOT SCREENED^L||540^NICU^ROBX|14|CE|534^HEARING CATEGORY^L||518^INITIAL^ROBX|15|CE|527^HEARING RISK FACTORS^L||OBX|16|CE|528^NEWBORN HEARING SCREEN^L||540^NICU^R|||||||||20050919^20050919OBX|17|CE|593^SPECIMEN QUALITY CODE^L||0OBX|18|CE|552^SPECIMEN QUALITY CODE 1^L||0OBX|19|CE|553^SPECIMEN QUALITY CODE 2^L||0OBX|20|CE|1^AMINO ACID DISORDERS^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|21|CE|545^BIOTINIDASE DEFICIENCY^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|22|CE|626^CYSTIC FIBROSIS^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|23|CE|4^FATTY ACID DISORDERS^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|24|CE|5^GALACTOSEMIA^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|25|CE|6^ORGANIC ACID DISORDERS^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|26|CE|546^HEMOGLOBINOPATHY^L||79^^L^NORMAL^^L||null|||||||200906170420OBX|27|CE|2^ENDOCRINE DISORDERS^L||558^^L^OH-C-03-003^THE SCREEN FOR CONGENITAL ADRENAL HYPERPLASIA IS ABNORMAL. FURTHER FOLLOW-UP IS NECESSARY TO EVALUATE THIS INFANT.^L||< 24 NG/ML|A||||||200906170420

HL7 NBS Message