Interoperability ShowcaseIn collaboration with IHE

Use Case 3

Care Theme: Leveraging National Healthcare Registries in Care Delivery

Biosurveillance Monitoring and Detection

This Scenario demonstrates interoperability between physician’s electronic health record (EHR) system, laboratory information management system (LIMS), local/state/national Public Health Infectious Disease Registry (surveillance system) . The scenario is focused on two conditions: tuberculosis and gastrointestinal illness.

Primary Goal: To support case detection and investigation for the reportable infectious diseases (conditions) using electronic information exchanges between clinicians, laboratories and public health registries.

Meaningful Use Relevance:This Scenario is responsive to the Meaningful Use (MU) of Health IT Objective 4: Improving Quality and Population Health.  

Key Points:• Provide laboratory information from LIMS to Public Health State Infectious Disease Registry on all

patients diagnosed with a reportable condition

• Provide clinical information from physician EHR to a local/state Public Health Infectious Disease Registry on all patients diagnosed with a reportable condition

• Public Health Reporting decision support triggered from the Health Information Exchange (HIE)

• Public Health Disease Monitoring

• Bi-directional interoperability between EHRs and Public Health with HIE support

• The use of Clinical Data Architecture (CDA) to define content for Public Health Reporting data exchange is demonstrated.

 

Care Theme: Leveraging National Healthcare Registries in Care DeliveryUse Case 3 : Biosurveillance Monitoring & Detection

Care Theme: Leveraging National Healthcare Registries in Care DeliveryUse Case 3 : Biosurveillance Monitoring & Detection

1- PCP 2- Lab 3- PCP 4- HIE/Value 5- Public Health 6- Public Health Added Services Infrastructure Disease Registry

1- Patient presents to Provider with symptoms of a condition to be reported to a Public Health Entity e.g., Tuberculosis (TB), Provider refers Patient to the Hospital Laboratory for a test. Specimen is collected at the Hospital Laboratory.

2- Specimen is analyzed and laboratory results indicate the reportable condition. The Test Result Report is sent to the ordering Provider's Electronic Health Record Systems (EHR) and Public Health Infectious Disease Registry using value-added services from the HIE for Direct communications, Transformation of structure and vocabulary, and document sharing submission.

3- The Test Results Report is available in the Provider's EHR through the HIE. Provider confirms that the Patient has a reportable condition (TB or ILI or GI). Summary Visit Document including the Test Results is sent to HIE for continuity of care. EHR sends the Initial Case Report to the Public Health Infectious Disease Registry.

4- The HIE offers value-added services: Analyzes HIE documents content to determine a reportable event; Send the Case Report to Public Health Infectious Disease Registry for a reportable condition;

5- Public Health Infrastructure Services are Provided for Form Management

6- Public Health Infectious Disease Registry receives the Laboratory Test Results Report and Case Report from Provider EHR and Hospital Laboratory directly or via the HIE. State Epidemiologist monitors the number of cases through visualization tools

Clinical Workflow:

Health Information Exchange (HIE) Core Services

IHE Profiles

XD*Lab Sharing Laboratory Reports

XDS-MS Medical Summaries

RFD Retrieve Form for Data Capture

PH-rpt QRPH White Paper on Public Health Reporting (New Directions)

The Direct Project SMTP Secure Health Transport, XDR Simple Health Transport

XCAXDS/XDR/XDM

Cross-community and Cross-enterprise Document Sharing

PIX Patient Identity Cross-reference

PDQ Patient Demographics Query

ATNA Audit Trail and Node Authentication

CT Consistent Time

Care Theme: Leveraging National Healthcare Registries in Care DeliveryUse Case 3 : Biosurveillance Monitoring & Detection

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