Xforms for Public Health: Notifiable Condition Case Reporting and Public Health Alerting Using IHE's RFD Profile

We explored bi-directional communication by implementing the Health Information Technology Standards Panel’s T50 Construct and the associated Integrating the Healthcare Enterprise (IHE) Retrieve Forms for Data Capture (RFD) Profile. We demonstrated two examples of public health (PH) - provider communication: PH alerting and notifiable condition reporting.  Both examples made use of RFD and the underlying Xforms standard within a model Health Information Exchange.  In the demonstration, a PH alert was triggered by a request from the provider’s Electronic Medical Record (EMR) system.  Patient information, in the form of a Continuity of Care Document (CCD), was sent to and parsed by the PH Forms Manager.  Based on fields in the CCD, e.g., zip code, a matching alert was returned and appeared within the provider’s EMR as an Xform.  The Xform alert lent support at the point of care in diagnosis and treatment.  The provider, when viewing an alert on a notifiable condition, e.g., Salmonella, was given the option to submit a case report by clicking a button on the alert form.  The case report form was then requested from the PH Forms Manager and the appropriate Xform was returned. Patient-specific data from the CCD was used to pre-populate the case report form; completed forms were submitted to the PH Forms Receiver.

We successfully demonstrated the use of RFD for two public health use-cases and found the profile to be promising.  With some improvements to the underlying Xforms standard as well as communities of practice to support the use of this technology, the future of RFD and Xforms looks positive. Use of these standards has the potential to streamline PH and provider workflow surrounding notifiable condition reporting, and to help PH communicate patient-specific alerts to providers at the point of care. Our presentation will describe the demonstration and lessons learned during implementation.