S&I PUBLIC HEALTH REPORTING INITIATIVE: DEVELOPING OF A TEAMING APPROACH

S&I Public Health Reporting Initiative

Nikolay Lipskiy, MD, DrPH, Co-Lead

September, 21st, 2011

BackgroundGoal of the initiative The goal of the S&I Public Health Reporting Initiative is to harmonize HIT standards and implementation guides for bi-directional interoperable communication between clinical care and public health entities for selected use cases.

Approach  I. Approach the creation of the implementation guide(s) so as to minimize unnecessary modification of EHRs and their certification by harmonizing with other ONC-certification criteria and other S&I Framework activities like the Transfer of Care (TOC) Initiative and others. II. Approach the creation of the implementation guide(s) in a way to maximize its future extensibility and re-usability to other public health reporting use cases. III. Minimize unnecessary impact on established MU Stage 1 public health reporting objectives while potentially simplifying such reporting in the future. IV. Enable bi-directional communication as needed for public health reporting use cases. V. Approach the creation of the implementation guide(s) so as to account for the needs of subsequent inter-jurisdictional communication (e.g. transfer of cases between jurisdictions and national notification requirements) and population-level reporting. VI. Facilitate future certification of public health information systems that are interoperable with ONC-certified EHRs.  

Background. Examples of S&I Framework Teaming and Descriptions of Workgroups at Wiki

Purpose•     The LRI Pilots Workgroup will support the LIS and EHR community in integrating and demonstrating the toolset provided by the LRI Validation Suite to (1) validate the ability of LIS and EHR systems to send and receive LRI-compliant lab test messages and (2) to determine the extent of EHR compliance with the CLIA requirements.Scope•     The scope of the LRI Pilots will be to demonstrate at a production level the transport of LRI-compliant laboratory results from LISs to ambulatory EHRs. ObjectivesShort-Term 1. Pilot testing of the LISs and EHRs that have agreed to implement the LRI IG 

specifications.2. Pilot LIS and EHR systems may use the LRI Validation Suite3. Build a list of potential Pilot participants4. Capture best practices from existing Lab Pilots  

Long-Term 1. Support ONC NHIN as they draft the MU Stage 2 requirements

Background. Examples of S&I Framework Teaming and Descriptions of Workgroups at Wiki

Public Health 

Reporting

* Adapted from the ONC S&I Standards Development Support page at: http://wiki.siframework.org/Standards+Development+Support

S&I Public Health Reporting Activity: Team Engagement Concept*

The diagram above depicts the inter-relationships of the S&I Framework functions, from a teaming perspective. This diagram  is developed based on the results of harmonization of standards across all steps in the S&I Framework, in parallel with the development of the implementation specifications.

The Information Exchange Package Documentation (IEPD) Artifacts*

IEPDs contain both required and 

recommended artifacts

Required : BoldRecommended : Italic

Note: Best practices for most 

organizations include many of the 

optional artifacts listed here

• Business Process• Use Cases

• Sequence Diagrams

• Business Rules • Business Requirements

• Exchange Content Model

• Mapping Document

• Subset Schema• Exchange Schema• XML Wantlist

•Constraint Schema•Extension Schema

•Main Document• IEPD Catalog• IEPD Metadata

•Sample XML Instances

•XML Stylesheets

Scenario Planning

Analyze Requirements

Map & Model

Build & Validate

Assemble & Document

Publish & Implement

No required artifacts. Publish the IEPD to a repository and implement the exchange

*Source: Doug Fridsma, at: http://www.google.com/url?sa=t&source=web&cd=1&sqi=2&ved=0CB8QFjAA&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fdocument%2F947907%2Fapplication_vnd_ms-powerpoint&rct=j&q=S%26I%20Governance&ei=oN94Tsf5C5TogQfI05nXDQ&usg=AFQjCNH-cviEuaqg4-bzMgPBD2r8mb02CQ&sig2=nQmnYGZ-Qf3jI8TqwmQNag

S&I Process for Documenting Workflow and Artifact Development (Artifacts, Roles and Controls)*

Core artifacts are versioned 

and controlled

Core artifacts are versioned 

and controlled

Artifacts are “packaged”

and released

Artifacts are “packaged”

and released

Each artifacts has a 

responsible role

Each artifacts has a 

responsible role

Artifacts and releases have prioritization and approval

points, or “controls”

Artifacts and releases have prioritization and approval

points, or “controls”

* Source: Doug Fridsma, 09-28-10,  at: http://www.google.com/url?sa=t&source=web&cd=3&sqi=2&ved=0CCoQFjAC&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fgateway%2FPTARGS_0_0_7660_3080_20704_43%2Fhttp%253B%2Fwci-pubcontent%2Fpublish%2Fonc%2Fpublic_communities%2F_content%2Ffiles%2Ffridsmapresentation_092810.ppt&rct=j&q=S%26I%20governance&ei=StZ4Tt2IO8nOgAfuvpHkDQ&usg=AFQjCNFCpiT1b5mo5V_x9JzPLtOYey-iZQ&sig2=WDmEgWGygzCWlKNW3CKAng

Data Drill-Down Process*

* Adopted from the ONC S&I Case Simplification Supplement at: http://wiki.siframework.org/file/view/ONC-SI-UC-Simplification-V1-Cover-20110715-Consensus.pdf 

Public Health Reporting ActivityPH

Reporting Use Cases

Action Drill-Down Process*

* Adopted from the ONC S&I Case Simplification Supplement at: http://wiki.siframework.org/file/view/ONC-SI-UC-Simplification-V1-Cover-20110715-Consensus.pdf 

Public Health Reporting ActivityPH

Reporting Use Cases

Recent Public Health Reporting Documents (Examples)

Use Case Development& Functional

Requirements

Use Case Development& Functional

Requirements

Implementation Specifications

Implementation Specifications

Standards Development and Support

Standards Development and Support

Harmonization of

Core Concepts

Harmonization of

Core Concepts

Certification and Testing

Certification and Testing

Pilot Demonstration

Projects

Pilot Demonstration

Projects

Reference Implementation

Reference Implementation

Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository,

Testing Scripts, etc.)

Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository,

Testing Scripts, etc.)

Architecture Refinement and ManagementArchitecture Refinement and Management

  1. Use cases and functional

requirements harmonization

(UCR)

  1. Use cases and functional

requirements harmonization

(UCR)

Public Health reporting WGs

  2. Vocabulary and Terminology

harmonization (VT)

  2. Vocabulary and Terminology

harmonization (VT)

 3. Reference Implementation

/Architecture (RI&A)

 3. Reference Implementation

/Architecture (RI&A)

  4. Certification   4. Certification

  5.   S&I Knowledgebase (S&I KB) / S&I KB Portal

  5.   S&I Knowledgebase (S&I KB) / S&I KB Portal

 6. Policy/Deployment (P&D)

 6. Policy/Deployment (P&D)

Governance Body

Governance Body

Potential S&I Public Health Reporting Activity Workgroups

Public Health Reporting Activity

Categories of Potential Deliverables Potential Workgroups/Activities

1.    Landscape of existing PH reporting scenarios, terminology and business process

1. Use cases and functional requirements harmonization2.Vocabulary and terminology harmonization5. S&I Knowledgebase/Tools (PHIN) 6. Policy/Deployment

2.  An implementation guide for most important use cases and reference implementation (potential testing process, validation tools, etc.). 

2.Vocabulary and terminology harmonization3. Reference Implementation (Testing)/Architecture,5. S&I Knowledgebase (S&I KB)/ S&I KB Portal 6.Policy/Deployment

3.    Vision on a certification of public health systems (purpose, criteria, potential certification entities and process, validation tools, etc.)

4. Certification, 5. S&I Knowledgebase (S&I KB)/ S&I KB Portal 6.  Policy/Deployment

Matrix of Potential Deliverables/Workgroups

Workgroup NamePurpose Scope Objectives

1. Use cases and functional requirements harmonization (UCR)      

2. Vocabulary and terminology harmonization      

3. Reference Implementation (Testing)/Architecture      

4.  Certification      

5.   S&I Knowledgebase (S&I KB)/ S&I KB Portal       

6.    Policy/Deployment      

Workgroups: Purpose, Scope and Objectives

Call for Participation

Please, submit your participation information through the S&I Public Health Reporting activity website at: http://wiki.siframework.org/Public+Health+Reporting+Initiative