Public Health Research - Case Reporting - overview
Developing a Public Health Approach for Implementation of the HL7 Clinical Document Architecture (CDA) Public Health Case Report (PHCR)
Electronic Health Record systems that create, transmit, receive, and display Continuity of Care Documents (CCD) as required under Meaningful Use have a framework that can serve as the basis for the creation of closely related documents that are needed within a document-based health information exchange. The HL7 Clinical Document Architecture (CDA) Public Health Case Report (PHCR) is one example: it leverages CCD sections (e.g., social history, medications, results, encounters, immunization) to transmit reportable condition information to public health entities as required under jurisdictional law. The CDA PHCR implementation guide (IG) was balloted by HL7 in 2009 with a base report and condition-specific reports for anthrax, acute hepatitis B, tuberculosis, and tularemia.
In 2011-2012, the Public Health Data Standards Consortium (PHDSC), in collaboration with the Centers for Disease Control and Prevention (CDC), Council of State and Territorial Epidemiologists (CSTE), and Association of Public Health Laboratories (APHL), renewed development of the HL7 PHCR IG, to support an additional set of reportable conditions. Following the leadership of the Office of the National Coordinator and Centers for Medicare and Medicaid Services our project utilizes Model Driven Health Tool (MDHT) as a framework for creating CDA constraints in a user-friendly interface. We created modular definitions (templates) in MDHT as inputs for automated IG generation and Java developer tooling (artifacts) for creating, validating, and consuming documents. In addition, we created condition-specific case reports; demonstrating a sample use case and the tool’s Application Programmer Interfaces (APIs). These templates and artifacts were contributed to the open source MDHT template library. Our goal is to provide clinical and public health organizations with meaningful examples and a ready-to-use template library, in order to begin a conversation around CDA based public health case reporting in state and local document exchanges with Electronic Health Records.