HL7 Electronic Health Record System (EHR-S) Public Health Functional Profile

(PHFP)Project

PHDSC Annual Business MeetingNovember 8, 2012

Hetty KhanHealth Informatics Scientist

Centers for Disease Control and PreventionNational Center for Health Statistics

National Center for Health Statistics

Classifications and Public Health Data Standards Staff

NCHS/PHDSC Collaboration on Standards Activities for Public Health

• NCHS supports the PHDSC’s goal to empower the healthcare and public health communities with health information technology standards to improve individual and community health

• NCHS provides support for PHDSC projects to develop Health Level Seven (HL7) International standards to support public health requirements

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Health Level Seven International (HL7)

HL7 VisionTo Create the Best and Most Widely Used Standards in Healthcare

HL7 MissionHL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all of our stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients

© 2002-2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off

What is the HL7 EHR-S Functional Model?

The EHR-S FM presents a superset of functions for an EHR system from which a user/setting specific subset can be generated

The HL7 EHR-S FM standard is consensus-based and internationally-oriented

Creates a common platform for providers, vendors, partners, stakeholders and others to describe needed EHR functionality

Direct Care

DC.1 Care Management

DC.2 Clinical Decision Support

DC.3 Operations Management and Communication

Supportive

S.1 Clinical Support

S.2 Measurement, Analysis, Research and Reports

S.3 Administrative and Financial

Information

Infrastructure

IN.1 Security

IN.2 Health Record Information and Management

IN.3 Registry and Directory Services

IN.4 Standard Terminologies & Terminology Services

IN.5 Standards-based Interoperability

IN.6 Business Rules Management

IN.7 Workflow Management

Functions describe the behavior of a system in user-oriented language so as to be recognizable to the key stakeholders of an EHR System

EHR-S Functional Model at a Glance

EHR-S FM Standard

What is a Functional Profile?

• An HL7 EHR-S Functional Profile is a subset of functions identified for a specific healthcare delivery setting or domain, for example:

• Long Term Care• Ambulatory Care• Behavioral Health• Pharmacy• Child Health• Clinical Research• Public Health

Public Health Functional Profile (PHFP) Project

Development of the PHFP is: funded by NCHS/CDC supported by the Public Health Data

Standards Consortium (PHDSC)

co-sponsored by :• HL7 Electronic Health Record Work Group• HL7 Public Health & Emergency Response

Work Group

Public Health Functional Profile

Public Health Functional Profile (PHFP):

Conforms to the HL7 EHR-S FM

Includes a subset of functions of the EHR-S FM required or desired for implementation in EHR systems or health care delivery settings to support the needs of public health and public health-clinical information exchanges for specific public health programs (domains)

NCHS/PHDSC Timeline for HL7 EHR-S FM Projects

2004

2008

2010

2011

2012

2013

Evaluation of EHR-S FM: Public Health Perspective

NCHS developed Vital Records Functional Profile (VRFP)

Re-evaluation of EHR-S FM R.1.1

PHFP Release 2: All previous domains and

adding9. Adverse

Events

PHFP Release 1.1, Version 2:4. Public Health Laboratory5. Occupational Disease6. Health Statistics7. Deep Vein Thrombosis8. Birth Defects

PHFP Release 1.1, Version 1:1. Vital Records2. Early Hearing Detection and Intervention3. Cancer

PHFP - Release 1.1, Version 12010 - 2011

PHFP - Release 1.1, Version 2 2011- 2012

PHFP - Release 1.1, Version 2 2011- 2012

Direct Care

DC.1 Care Management

DC.2 Clinical Decision Support

DC.3 Operations Management and Communication

Supportive

S.1 Clinical Support

S.2 Measurement, Analysis, Research and Reports

S.3 Administrative and Financial

Information

Infrastructure

IN.1 Security

IN.2 Health Record Information and Management

IN.3 Registry and Directory Services

IN.4 Standard Terminologies & Terminology Services

IN.5 Standards-based Interoperability

IN.6 Business Rules Management

IN.7 Workflow Management

Functions describe the behavior of a system in user-oriented language so as to be recognizable to the key stakeholders of an EHR System

EHR-S Functional Model at a Glance

EHR-S FM Release 2 Chapter Reorganization

Overarching (O)

Care Provision (CP)

Care Provision Support (CPS)

Population Health Support (POP)

Administrative Support (AS)

Record Infrastructure (RI)

Trust Infrastructure (TI)

Direct Care (DC)

Supportive (S)

Information Infrastructure (IN)

The R1.1 Direct Care and Supportive Functions have been regrouped into four Chapters:

Release 2 Reorganization

Care Provision Support

CPS.1 Record ManagementCPS.2 Support Externally-sourced Information CPS.3 Support Clinical Documentation CPS.4 Support OrdersCPS.5 Support ResultsCPS.6 Support Treatment Administration CPS.7 Support Future CareCPS.8 Support Patient Education & Communication

CPS.9 Support Care Coordination & Reporting

Care Provision

CP.1 Manage Clinical HistoryCP.2 Manage Externally-sourced InformationCP.3 Manage Clinical DocumentationCP.4 Manage OrdersCP.5 Manage ResultsCP.6 Manage Treatment AdministrationCP.7 Manage Future CareCP.8 Manage Patient Education & Communication

CP.9 Manage Care Coordination & Reporting

Release 2 ReorganizationPopulation Health Support

POP.1 Support for Health Maintenance, Preventive Care and WellnessPOP.2 Support for Epidemiological Investigations of Clinical Health Within a PopulationPOP.3 Support for Notification and Response

POP.4 Support for Monitoring Response Notifications Regarding a Specific Patient’s HealthPOP.5 Donor Management SupportPOP.6 Measurement, Analysis, Research and ReportsPOP.7 Public Health Related UpdatesPOP.8 De-Identified Data Request Management

POP.9 Support Consistent Healthcare Management of Patient Groups or PopulationsAdministration support

AS.1 Manage Provider Administrative Information

AS.2 Manage Patient Administrative Information AS.3 Manage Personal Health Record Administration AS.4 Manage CommunicationAS.5 Manage Clinical Workflow TaskingAS.6 Manage Resource Availability

AS.7 Manage Encounter/Episode of Care Administration

AS.8Manage Financial Transaction Processing

Release 2 Reorganization

The R1.1 Infrastructure support Functions have been regrouped into two Chapters:

Record Infrastructure

RI.1 Record Management

RI.2 Record Synchronization

RI.3 Record Archive

Trust Infrastructure

TI.1 SecurityTI.2 AuditTI.3 Registry and Directory ServicesTI.4 Standard Terminology and Terminology ServicesTI.5 Standards-Based InteroperabilityTI.6 Business Rules ManagementTI.7 Workflow ManagementTI.8 Database Backup and Recovery

TI.9 System Management Operations and Performance

PHFP Transition - Release 22012 - 2013

Public Health Functional Profile may:

Lay the foundation for developing a Public Health Information Systems (PHIS) Functional Model

• Include functions and criteria applicable to PHIS

• 2012-2013 Project Task: – Analyze the PHFP R2 to determine the core set of

functional requirements that are common to all public health domains included in the profile, identifying potential areas for harmonization

Public Health Functional ProfilePurpose and Vision

Public Health Functional Profile: Vision

Public Health Laboratory

Cancer Registries Occupation

al Disease

Vital Records

EHDI Common Public Health

FunctionsHealth Statistics

Birth Defects

DVT/PE

Adverse Events

Plans for PHFP Certification2012-2013

Serve as a reference for certification of EHR systems that include functionality to support PH domains

2012 – 2013 Project Task:

Meet with public health and EHR certification experts to review and discuss the PHFP and to determine how it may serve as the infrastructure to support certification of EHR systems that meet PH requirements for the public health domains included in the PHFP

Develop recommendations on EHR systems certification based on the outcomes of the review and discussion of the PHFP by the certification experts

Functional Profiles

Questions?

National Center for Health Statistics

Classifications and Public Health Data Standards Staff