APHL-PHDSC CollaborationStandards in the laboratory realm

November 9th , 2012PHDSC Annual Meeting

Riki Merrick, MPH Contractor to Association of Public Health

Laboratories

PHDSC 2012

Overview

Collaboration between APHL and PHDSC

2011-2012 White Paper with 2 parts– Standards in use in the Public Health Laboratory (PHL)

domain– Roadmap to HIT standardization for PHL

2011-2013 PH functional model for EHRsystems for PHL

2012-2013 PHL result reports using CDA templates

PHDSC 2012

White Paper – Part 1

http://www.phdsc.org/standards/pdfs/PHDSC-APHL_PHL_Standards_White-Paper_Part-1FINAL_v1.pdf

PHDSC 2012

White Paper – Part 2

http://www.phdsc.org/standards/pdfs/PHDSC-APHL_PHL_Standards_White-Paper_Part-2FINAL_v1.pdf

CSTE 2012

PHDSC HIT Standardization Framework

CSTE 2012

PH functional model for EHRsystems

Defines EHRsystem requirements to support data exchange with PHL• HL7 working group expansion of

existing functional standard to include several new PH domains, including PHL

• PHDSC facilitated calls with full domain representation

PHDSC 2012

PH functional model for EHRsystems (cont.)

VR = Vital RecordsEDHI = Early Hearing Detection and InterventionCAN = Chronic Disease Cancer SurveillanceODIF = Occupational Disease, Injury, and Fatality HS = Health StatisticsDVT = Deep Vein Thrombosis and Pulmonary EmbolismBD = Birth DefectsAE = Adverse Events

PHDSC 2012

CDA templates for lab result reports

PHLs should consider using CDA: • EHRsystems natively produce CDA • PHLs need human readable results to support CLIA

compliance

but• PHL result reports usually covered by HL7 v2 messages,

where data is highly structured

so• existing CDA templates may need extensions

PHDSC 2012

CDA templates for lab result reports

• Builds on PH case reporting project using CDA• Creation of CDA lab result model in the Model Driven

Health Tool (MDHT) to create the base template• Application of the base template to 15 disease test

cases – proposed are:Influenza Salmonella

Bordetella pertussis Neisseria meningitidisMycobacterium tuberculosis West Nile virus

Blood lead StaphlyococcusHepatitis (A, B, C) Streptococcus pneumoniae

Chlamydia trachomatis Neisseria gonorrhoeaeHaemophilus influenzae Bacillus anthracis

Francisella tularensis

PHDSC 2012

Benefits of Collaboration

• Expertise on both sides is combined– PHDSC:

• Advocacy• Policy development activities (HITSP)• Standards development • CDA • Implementation testing

– APHL:• Advocacy and informatics policy • Standards development • Lab domain expertise• HL7 message implementation guide development and

deployment • Hands on Technical Assistance program for data exchange

implementations

PHDSC 2012

Questions/Contact

Riki Merrickrmerrick@iconnectconsulting.com

Michelle Meigsmichelle.meigs@aphl.org

PHDSC 2012

Glossary

AE Adverse EventsAPHL Association of Public Health LaboratoriesBD Birth DefectsCAN Chronic Disease Cancer SurveillanceCDA Clinical Doument ArchitectureCLIA Clinical Laboratory Improvement AmendmentsDVT Deep Vein Thrombosis and Pulmonary EmbolismEDHI Early Hearing Detection and InterventionEHR Electronic Health RecordEIN Employer Identifaction NumberHIPAA Health Insurance Portability and Accountability ActHIT Health Information TechnologyHL7 Health Level SevenHS Health StatisticsIHE Integrating the Healthcare EnterpriseLOINC Logical Observation Identifiers Names and CodesMDHT Model Driven Heatlh ToolsNPI National Provider IdentifierODIF Occupational Disease, Injury, and Fatality PH Public HealthPHDSC Public Health Data Standards ConsortiumPHIN MS Public Health Information Network Messaging ServicePHL Public Health LaboratoryRIM Reference Information ModelSNOMED Systematized Nomenclature of MedicineUCUM Unified Code for Units of MeasureVR Vital Records