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Sunday, August 24, 2008
South/West Halls
Background: Public health surveillance requires that clinicians report selected notifiable conditions to public health authorities within a stipulated period. Notifiable condition reports are used by public health to detect outbreaks and aid in the implementation of control measures. Often, the process used to report notifiable conditions is paper-based and suffers from delayed reporting. There are no standards for automated case reporting from an electronic health record (EHR) to public health.
Objective: As part of the Utah Center of Excellence in Public Health Informatics, we aimed to model a case report using HL7 to electronically transmit case reports and supporting laboratory information from an EHR to public health.
Methods: We reviewed guidelines for the electronic transmission of nationally notifiable conditions from public health entities to the CDC (PHIN implementation guide, 2007) and ELR standards for laboratory reporting associated with notifiable conditions. In addition, we considered Confidential Morbidity Report fields defined by a national workgroup led by CDC and CSTE. Finally, we ascertained requirements from local and state public health practitioners, and reviewed fields currently and potentially included in case reports automatically generated from the Intermountain Healthcare EHR through the Rhapsody Engine.
Results: We modeled an HL7 version 2.5 message to transmit case reports from an EHR to Public Health. We based the model on the PHIN implementation guide for reporting to CDC, but used more standard HL7 fields. For example, we use the PV1 segment for patient visit information. We are requesting new LOINC concepts.
Conclusion: We created a standards-based model for transmission of case information and supporting evidence. We will work with a standards development organization (Utah Health Information Network) to formalize the standard to comply with a new Utah law requiring the use of standards for electronic health information exchange. We will report on progress with development and testing.
Objective: As part of the Utah Center of Excellence in Public Health Informatics, we aimed to model a case report using HL7 to electronically transmit case reports and supporting laboratory information from an EHR to public health.
Methods: We reviewed guidelines for the electronic transmission of nationally notifiable conditions from public health entities to the CDC (PHIN implementation guide, 2007) and ELR standards for laboratory reporting associated with notifiable conditions. In addition, we considered Confidential Morbidity Report fields defined by a national workgroup led by CDC and CSTE. Finally, we ascertained requirements from local and state public health practitioners, and reviewed fields currently and potentially included in case reports automatically generated from the Intermountain Healthcare EHR through the Rhapsody Engine.
Results: We modeled an HL7 version 2.5 message to transmit case reports from an EHR to Public Health. We based the model on the PHIN implementation guide for reporting to CDC, but used more standard HL7 fields. For example, we use the PV1 segment for patient visit information. We are requesting new LOINC concepts.
Conclusion: We created a standards-based model for transmission of case information and supporting evidence. We will work with a standards development organization (Utah Health Information Network) to formalize the standard to comply with a new Utah law requiring the use of standards for electronic health information exchange. We will report on progress with development and testing.
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