Use Case 16

Use Case 16

Care Theme: Maternal & Newborn HealthUse Case: Vital Registration and Care Coordination for Newborn Hearing Screening

Primary Goal: Demonstrates information flow related to vital registration, newborn hearing screening, care coordination, and quality measures that occur after baby is delivered.  Newborn hearing screening is conducted after delivery. Results are transmitted to state public health's Early Hearing Detection and Intervention (EHDI) information system (IS) to prepare an Early Hearing Care Plan (EHCP). Care coordination is demonstrated by sharing EHCP with each baby's pediatrician. Demonstrates interoperability between Birthing Facility Electronic Health Record (EHR) and State Vital Records’ IS. Pediatric quality measure as defined by CDC are computed by quality measurement service provider.

Key Points:• The demonstration uses multiple IHE profiles to show exchange of medical information between EHR Systems and the

development of long-term, quality health care plans based upon state /government historical information.

Meaningful Use Relevance: Improving Quality, Safety, Efficiency, and Reducing Health Disparities

Domain Profile Vendors Actors

IT Infrastructure (ITI)

PIX, PIXv3 Oracle, Intersystems PIX Manager

PDQ Oracle, Intersystems PDS Server

XCA Oracle, Intersystems Initiating Gateway, Responding Gateway, Registry

XCPD Oracle, Intersystems Initiating Gateway, Responding Gateway

XDS Oracle, Intersystems Document Registry, Document Repository

Patient Care Coordination (PCC)

APS GMT, Epic Content Creator, Content Consumer

LDS Epic Content Creator

Quality, Research and Public Health

(QRPH)

EHCP CDC-OZ, GMT Content Creator, Content Consumer

NANI Epic, CDC-OZ, Intersystems Subscriber, Manager, Information Source

BFDR Epic, CDC-OZ, Genesis, Utah DPH, Minnesota DPH Form Filler, Form Manager, Form Receiver

QME-EH CDC-OZ, Intersystems Content Creator, Content Consumer

IHE

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Care Theme: Maternal & Newborn HealthUse Case 16: Vital Registration and Care Coordination for Newborn Hearing Screening

4. Hearing screening results from Patient Care Device (PCD01) capture and/or Birthing Facility’s EHR are transmitted to EHDI Program responsible for creating an Early Hearing Care Plan (EHCP). EHCP generated from EHDI-IS communicates newborn’s hearing screening outcome and jurisdiction-specific guidelines for follow-up care to Pediatrician EHR through HIE. Quality Measure Execution information (QME-EH) uses NANI and EHCP available in EHDI IS to send to the HIE analytics to measure and monitor Meaningful Use Measure: NQF 1354: EHDI-1a—Hearing Screening prior to Hospital Discharge). 5. Pediatrician receives and reviews Early Hearing Care Plan prior to well-child visit6. Number of births (denominator) using NANI and the outcome of newborn hearing screening (numerator), are used to compute the percentage of babies receiving screening prior to Hospital Discharge - Meaningful Use eMeasures via HIE Analytic value added services. 7. CDC/NCHS receives birth certificate information from all vital records jurisdictions. Statistics are collected and analyzed to monitor the demographic and health status of the population and for epidemiologic research.

1. OB/GYN or certified nurse/midwife (CNMW) collects mother’s demographic information and medical history during prenatal care and provides antepartum summary, antepartum history and physical (AP*) documents which will be available to the labor and delivery department when the mother gives birth. 2 Expectant mother arrives at Birthing Facility where, following delivery, her clinical details from birth and initial post-partum period are captured on Labor and Delivery Summary (LDS) in Birthing Facility EHR. Newborn Admission Notification Information (NANI) on each newborn is sent to EHDI IS as a timely denominator of hospital births. Relevant health information from LDS is sent to pre-populate the Birth and Fetal Death Report (BFDR) electronic form. Clinician reviews and edits information in pre-populated electronic BFDR for completeness and accuracy. Upon approval, the information from the Form populates the state/jurisdiction’s Electronic Birth Registration System. NANI sends each Newborn’s demographics to EHDI IS. 3. Birthing Facility EHR sends clinical data to State Public Health to pre-populate electronic Vital Records Facility Worksheet. Completed information is transmitted to the appropriate jurisdictional authority for birth registration and production and dissemination of local and national birth statistics.

Clinical Workflow:HIE1| HIE2 HIE2| HIE1

5. Pediatrician Retrieves EHCP and NDS

6. HIE Computes eMeasures

1. OB/GYNCollect prenatal care info

2. Labor & DeliveryCollect birth/post-partum info

3. Public Health Reporting

4. Public Health Entity Hearing Screening Received & Evaluated

7. CDC/NCHS Receives info; collects statistics for research

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