The Implementation of Clinical Document Architecture for the Electronic Submission of Healthcare-Associated Infection Data to the National Healthcare Safety Network

The Division of Healthcare Quality Promotion (DHQP), Centers for Disease Control and Prevention (CDC), is partnering with Health Level Seven (HL7), the Association of Professionals in Infection Control and Epidemiology, and infection surveillance software system vendors to develop a standards-based, vendor-neutral technical solution that enables hospitals that use vendor infection surveillance systems to report healthcare- associated infection (HAI) data to the CDC's National Health Safety Network (NHSN). As a result of DHQP coordination and support, a Clinical Document Architecture (CDA) Draft Standard for Trial Use for reporting HAI data has been developed, balloted successfully through HL7, and published. HL7 CDA is an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. CDA also lends itself for use by public health agencies and their partners as an interoperability specification for exchanges of structured reports. CDA is derived from the HL7 Reference information Model and uses HL7 data types and vocabulary, including coding systems--such as SNOMED and LOINC--to represent concepts. In this presentation, we will describe the rationale for using CDA to meet the technical requirements for HAI data exchanges, explore the operational challenges of using CDA for public health reporting purposes, and review lessons learned and successes of bringing the new emerging standard of CDA to the public health domain. CDA for HAI reporting is one of the first public health uses of CDA. Progress to date augurs well for other public health applications of this important interoperability standard.