HL7 Child Health Work Group Update HL7 EHR-Public Health Task Force Andy Spooner, MD CMIO,...

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


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

1. CHILD HEALTH WORK GROUP OVERVIEW


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


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

2. HL7 EHR-SYSTEM FUNCTIONAL MODEL


Functional Standards: Relationships of Artifacts

3. HL7 CHILD HEALTH FUNCTIONAL PROFILE FOR EHR SYSTEMS


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


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


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

4. CCHIT CHILD HEALTH WORK GROUP


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

5. GAP ANALYSIS WORK


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

6. WHAT’S NEXT


What’s Next

1. Input into EHR FM R22. Child Health Profile R23. Derived Profile for Neonatology

7. Q&A


Contact Information

Andy Spooner, MD, FAAPChief Medical Information OfficerCincinnati Children’s Hospital and Medical [email protected](513) 803-0121

HL7 Child Health Work Group Update HL7 EHR-Public Health Task Force Andy Spooner, MD CMIO,...

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