Post on 26-Jul-2020
HL7 Immunization User Group
Monthly Meeting
February 14, 2019
2:00 PM ET
Agenda
▪ Welcome▪ Poll: Which perspective do you primarily identify yourself with?
▪ Submit an abstract for the AIRA 2019 National Meeting by February 24.
▪Updates▪ SISC
▪ Presentations▪ Acknowledgements to Identify Data Quality Issues
▪ Client Completeness
SISC UpdateMary Woinarowicz
Acknowledgments to Identify Data Quality IssuesKevin Snow, Envision
HL7 Data QualityHarmonizing HL7 Validation with the AIRA Data Validation Guide and
National Error Code Set Guidance
Jan 2019
Completeness
Consistency Accuracy
Timeliness
Validity
The 5Ws (and H)
Who• The IIS
What• Implement or harmonize with existing data accuracy checks and error codes
Where• HL7 Response Messages
When• In real time
Why• Quick to find, quick to fix. Easier when in harmony with existing resources.
How• …and request for feedback!
High Priority accuracy validation
BR-101: Vaccination Encounter Date must not be before Patient Date of Birth
HL7 Data Quality StatementAIRA-DV-BR-101: RXA-3 (DateTimeStartOfAdministration) must not be before PID-7 (DateTimeOfBirth) when RXA-21 (ActionCode) is not valued "D“.
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
2204^Vaccination Date Too Long Ago^HL70533
High Priority accuracy validation
BR-103: Vaccination Encounter Date must be less than or equal to (before or the same as) the Submission Date
HL7 Data Quality StatementAIRA-DV-BR-103: RXA-3 (DateTimeStartOfAdministration) must be less than or equal to (before or the same as) MSH-7 (DateTimeOfMessage) when RXA-21 (ActionCode) is not valued "D".
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
1^Illogical Date error^HL70533
High Priority accuracy validation
BR-107: Every administered vaccine should be recorded as a single Vaccination Event (e.g., combo vaccine should be recorded as 1 event rather than separate events for each component)
Not ImplementedWas unsure how to implement due to:
• Immunizations can be split into multiple messages• Even if it’s in a single message the components could be out of order
High Priority accuracy validation
BR-114: Vaccination Encounter Date should not be the same as the Patient Date of Birth unless it is on the list of vaccines recommended for administration on the date of birth, e.g., HepB
HL7 Data Quality StatementAIRA-DV-BR-114: RXA-3 (DateTimeStartOfAdministration) should not be the same as PID-7 (DateTimeOfBirth) unless it is on the list of vaccines recommended for administration on the date of birth, e.g., HepB when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D“.
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
1^Illogical Date error^HL70533
High Priority accuracy validation
BR-116: Manufacturer and CVX Code should not contradict one another
Not ImplementedWas unsure how to implement due to:
• How to address case of manufacturer buys out another manufacturer. Does the code change? Do we need history of this to allow multiple values? Is there a challenge with keeping this up to date?
Functional Guide Vol 2-Review Draft 1.7.19.docx
High Priority accuracy validation
BR-118: Vaccination Encounter Date should not be after the lot number expiration date
HL7 Data Quality StatementAIRA-DV-BR-118: RXA-3 (DateTimeStartOfAdministration) should not be after RXA-16 (SubstanceExpirationDate) when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D".
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
2001^Conflicting Administration Date and Expiration Date^HL70533
Medium Priority accuracy validation
BR-119: Route and Site should not contradict each other for a given Vaccine Type and Patient’s age
HL7 Data Quality StatementAIRA-DV-BR-119: RXR-1 (Route) and RXR-2 (AdministrationSite) contradict each other for the given Vaccine Type in RXA-5 (AdministeredCode) and Patient’s age on RXA-3 (DateTimeStartOfAdministration) when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D".
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
3^Illogical Value error^HL70533
High Priority accuracy validation
BR-121: Administered vaccinations coded with an “unspecified” CVX code (should have specific Vaccine Types, e.g., Hib PRP-OMP; unspecified vaccine types, e.g., Hib, unspecified formulation)
HL7 Data Quality StatementAIRA-DV-BR-121: RXA-5 (AdministeredCode) should not be valued with an “unspecified” vaccine when the first occurrence of RXA-9.1 is valued "00" and RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D".
When the above data quality statement is violated then return
ERR-3 (HL7ErrorCode)
3^Illogical Value error^HL70533
High Priority accuracy validation
BR-130: Doses should not be recorded as given before the minimum patient age or after the maximum patient age for that particular vaccine
HL7 Data Quality StatementAIRA-DV-BR-130: Patient's age on RXA-3 (DateTimeStartOfAdministration) should not be before the minimum patient age or after the maximum patient age for the given Vaccine Type in RXA-5 (AdministeredCode) when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D".
When the above data quality statement is violated then returnNext slide…
BR-130 cont.
ERR-3 (HL7ErrorCode)
3^Illogical Value error^HL70533
ERR-7(DiagnosticInformation)
NumericPath: RXA[1].3[1].1, NamePath: ORDER[0]/RXA/DateTimeStartOfAdministration/Time, RuleId: , ApplicationErrorCode: AIRA-DV-BR-130, AIRA Data Validation Guide Rule: BR 130, Maximum Date: 20180101, Administration Date: 20181217, Days Difference: 350
ERR-8 (UserMessage)
RXA-3 (DateTimeStartOfAdministration): Patient's age on this date should not be before the minimum patient age or after the maximum patient age for the given Vaccine Type in RXA-5 (AdministeredCode) when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D". Please see BR-130 in the AIRA Data Validation Guide.
When the above data quality statement is violated then return
Test and Document Like Crazy
Client CompletenessShannon Coleman, STC
Michelle Middaugh, STC
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Client Completeness
Shannon Coleman and
Michelle Middaugh
Scientific Technologies
Corporation
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Electronic Interface
User Interface
How does patient and vaccination information get into IWeb?
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STC Data Quality SummitFebruary 12-13, 2019
Attendees: Client Interoperability experts, AIRA representatives and STC staff
Purpose: Discuss data quality challenges, best practices○ Bad Merges/Duplicate Records○ Address Cleansing○ Homeless Populations○ Patient Active/Inactive Status & Patient○ Ownership
Programmatic decisions
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Opportunity to align with national guidanceIIS DATA QUALITY PRACTICES TO MONITOR AND
EVALUATE DATA AT REST
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Where do you start?
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It’s hard to assess any other dimension if the data isn’t being recorded in the registry in the first place.
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Considerations for Completeness
• Does IWeb store the data element?• Is it a required data field in the UI?• Can it be required? Is it technically possible?• Is the data element required via HL7?• Does my issue resolution and import profile support the
expected conformance?• Policies and Local decision-making: Should it be mandatory
for our providers?• Does conflict exist between PHC Hub and IWeb?
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Client Completeness Configuration
HL7 Crosswalk
For each Data Element• Corresponding HL7 field• Conformance from HL7 Implementation Guide• Conformance from Local HL7 Implementation Guide• Current settings within IWeb • Current Import Profile and Issue Resolution settings within
PHC Hub
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HL7 Crosswalk
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Client Completeness Configuration Report Card
• Establishes baseline by measuring completeness for Patient Demographic and Vaccination Event Data Elements
• Benchmarks against Target Level established by Data at Rest Guidance
• Indicates optimal configuration of current functionality• Identifies possible areas of conflict or inconsistency• Provides actionable recommendations to improve
completeness measures
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Client Configuration Completeness
Report Card
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STC Next Steps
• Automate currently manual reports • Link in PHC Hub for Import profile settings• Drilling down into the details during Consortium calls • Backlog items for new data fields
• Standardize naming conventions
• Follow-up one on one calls
Next MeetingMarch 14, 2019
2:00 pm ET / 11:00 am PT
More Information
• Web Links• Subscribe to immunization group
http://www.hl7.org/participate/UserGroups.cfm?UserGroup=Immunization
• Public User Group Wiki http://www.hl7.org/special/committees/iug/index.cfm
• Private User Group Wiki http://iugwiki.hl7.org/
• HL7 Press Releasehttp://www.hl7.org/documentcenter/public_temp_F760602A-1C23-BA17-0C0D326E635471F9/pressreleases/HL7_PRESS_20140402.pdf
• AIRA Press Releasehttp://www.immregistries.org/events/2014/04/10/hl7-immunization-user-group
Contact Information
If you have any questions or comments:
▪ Kim Salisbury-Keith Kim.SalisburyKeith@health.ri.gov
▪ Nathan Bunker nbunker@immregistries.org
▪ Kevin Snow ksnow@envisiontechnology.com
▪ Danny Wise Danny.Wise@allscripts.com
Thank you!