Laying the Foundation for Vital Records Standards

Transcription

1 Laying the Foundation for Vital Records Standards PHDSC Annual Meeting November 12, 2008 Hetty Khan, RN, MS, MGA Michelle Williamson, RN, MS Health Informatics Specialists CDC/National Center for Health Statistics (NCHS)

2 Topics Overview of Vital Records (VR) Landscape NCHS Standards Initiatives Health Level 7 (HL7) Vital Records Domain Analysis Model (VR DAM) HL7 Electronic Health Record System (EHR-S) VR Functional Profile

3 Current Vital Records Landscape A significant number of data items on birth and death certificates are captured in medical records Facility Worksheet: o o Contains 41 major categories of data collection about the birth event and fetal death 36 of these data items can be collected from the medical records of the mother or child

4 Proposed Future VR Landscape Capturing VR Data at the Point of Care or Contact Registrar Department of Health Electronic Medical Record NCHS

5 Laying the Foundation Debates abound about the: Use of EHR as a source for VR information Benefits of EHR approach to VR community Improvements in quality and timeliness of VR data Reductions in the redundancy of data captured

6 Laying the Foundation It is worthwhile to lay the foundation for standardizing transmission of birth and death events as efforts towards developing and implementing EHRs continues

7 NCHS Standards Initiatives HL7 Vital Records Domain Analysis Model HL7 EHR-S Vital Records Functional Profile

8 Vital Statistics Standards Committee (VSSC) Participants include: NCHS Division of Vital Statistics (DVS) Classifications and Public Health Data Standards Staff (CPHDSS) National Association for Public Health Statistics and Information Systems (NAPHSIS) States Department of Health Provides support for development of HL7 electronic standards for transmission of data to and from VR systems to facilitate capturing VR data at the point of contact or point of care

9 HL7 VR Domain Analysis Model Serve to identify the birth and death registration work flow processes and stakeholders Provide an HL7 recognized format for representing the model to facilitate standards efforts * HL7 Domain Analysis Model is the artifact produced from requirements analysis that provides a synthesis of both information and behavioral requirements in a formal language (UML) using a common style Serve to guide future design and implementation efforts for standardizing the electronic data exchanges between VR systems and other public and private information systems *Source: HL7 Development Framework -

10 VR Birth Activities Model

11 VR Death Class Model

12 Next Steps for the HL7 VR DAM Continue to refine the VR DAM Incorporate modifications from the VSSC & HL7 Public Health and Emergency Response WG Broader outreach through NCHS sponsored pilot project webinar Identify scope for future development of messages, and/or structured documents

13 NCHS Standards Initiatives HL7 Vital Records Domain Analysis Model HL7 EHR-S Vital Records Functional Profile

14 EHR-S Functional Model Standard The EHR-S FM presents a superset of functions for an EHR system from which a user/setting specific subset can be generated It lists all of the functions that an EHR-S SHALL, SHOULD or MAY perform Creates a common platform for providers, vendors, payers and others to describe needed EHR functionality

15 Overview of the EHR-S FM Standard Direct Care Supportive DC.1 DC.2 DC.3 Care Management Clinical Decision Support Operations Management and Communication S.1 Clinical Support S.2 Measurement, Analysis, Research and Reports S.3 Administrative and Financial Functions describe the behavior of a system in useroriented language so as to be recognizable to the key stakeholders of an EHR System IN.1 Security Information Infrastructure IN.2 IN.3 IN.4 IN.5 IN.6 Health Record Information and Management Registry and Directory Services Standard Terminologies & Terminology Services Standards-based Interoperability Business Rules Management Source: HL7 EHR-S FM Overview Chapter IN.7 Workflow Management

16 EHR-S VR Functional Profile EHR-S Functional Profile Subset or profile of functions sought or available for certain EHR Systems, or healthcare delivery settings Profiles conform to the Functional Model EHR systems conform to a Profile VR Functional Profile Specify the functional requirements needed to support messaging among providers, states, local registrars and Federal agencies Serve as a source of reference for the Certification Commission for Health Information Technology (CCHIT) to consider for future certification of EHR systems that include functionality to better support vital registration

17 EHR-S Vital Records Functional Profile Project Timeline January 2008 Project officially approved by HL7 February March 2008 Call for Participation 85 participants Federal, state and local vital records representatives Electronic Health Records and vital records systems developers Healthcare providers Subject matter experts Other stakeholders April 2008 May 2009 (until complete) Profile Development

18 Task Groups: Birth Records Death Records Tasks: EHR-S VR Functional Profile Workgroups Each group meets bi-weekly Map Model Vital Events Registration System (MoVERS) functional requirements Map U.S. Standard Birth/Death Certificate Edit Specifications Identify VR functions and conformance criteria Identify gaps and incorporate into VR profile Obtain consensus on VR functions

19 Next Steps for VR Functional Profile Continue Task Group activities to develop VR Functional Profile Register the Profile with HL7 Consider balloting profile as an HL7 informative standard Conduct outreach explaining the value proposition to partners and key stakeholders Consider presenting a proposal to the Certification Commission on Health Information Technology to explore developing certification criteria for EHR-S VR products

20 Hetty Khan (NCHS) Contacts Michelle Williamson (NCHS)

21 Questions?