Download Access to Care - Public Health Data Standards Consortium

Report on the Population Health
Surveillance Committee
Federal Information Architecture
Steven J Steindel, Ph.D.
Senior Advisor, Data Standards and Vocabulary
Centers for Disease Control and Prevention
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CHI
FHA
• Consolidated Health Informatics (CHI)
• OMB eGov project started 2004
• Focus on Federal terminology exchange standards
• Investigated 24 health care domains and selected
standards in about half
• FHA
• Outgrowth of CHI
• Expands scope to all Federal heath care IT
• Intent is to form common IT architecture across
ALL agencies
• Both FHA and CHI now under ONCHIT
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CHI Terminology Domains
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Lab Results Name*
Messaging*
Medications*
Interventions/
Procedures
• Lab Test Orders*
• Non-laboratory*
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Demographics*
Immunizations*
Lab Results Content*
Clinical Encounters*
Nursing*
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Diagnosis/
Problem List*
Medical Devices/
Supplies
Anatomy*/
Physiology
Population Health
History and Physical
Multimedia
Text Based Reports*
Genes and Proteins
Disability
* Recommendation Made
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CHI Summary
Terminology Recommendations
• HL7
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Messaging
Demographics
Immunizations
Clinical Encounters
Text Based Reports
(CDA)
• SNOMED CT
• Interventions/
Procedures: Non-lab
• Lab Results Content
• Nursing
• Diagnosis/
Problem List
• Anatomy
• LOINC
• Lab Results Name
• Lab Test Orders
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FHA Workgroups
• Food Safety
• Safety of food supply
• USDA and FDA
primary agencies
• CDC monitor role
• Health Services and
EHR
• Clinical care systems
• DoD and VA primary
agencies
• No CDC involvement
• Interoperability
• Technical
interoperability
specifications
• Initial focus on
exchange protocols
• ONCHIT and HHS
primary
• Active CDC role
• PH Surveillance
• Surveillance
architecture
• CDC and VA primary
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FHA Line of Business Initiative (current)
Access to Care
Population
Health Mgmt.
Health Care
Services
Food and Nutrition
Assistance
Manage Enrollment
and Eligibility
Perform Assessment
and Plan for Care
Schedule Services and
Check-in
Manage Patient
Movement and Patient
Encounter
Support Beneficiary
Services
Assess Effectiveness
of Access to Care
Support Community
Outreach
Public Health
Surveillance
Health Determinants
Epidemiologic Studies
Vital Statistics
Health Surveys
Health Risk
Assessment
Detection
Information
Dissemination
Prevention & Exclusion
of Animal and Plant
Pests and Diseases
Invasive Species
Management
Interdiction of Smuggled
or Illegal
Trade/Transport
Animals or Plants
Define and Assess
Population
Develop Population
Health Management
Practices
Implement Tools /
Manage Processes
Evaluate Population
Health Management
Patient Education
Immunization
Management
Managed Services
Quality of Caresustaining
Emergency
Response
Outbreak
Investigation and
Intervention
Technical Assistance
and Consultation
Program
Implementation
Assess Beneficiary
Health Status
Plan Health Services
Deliver Health
Services
Manage
Information/Manage
Documentation
Coordinate and
Integrate Health
Services
Ensure Quality of
Health Services
Health
Advancement
Diagnostics and Clinical
management
Quality of Care-improving
Illness Prevention
Conduct Health Related
Research
Laboratory Research
Epidemiologic Methods
Research
Prevention Research
Survey and Statistical
Methods Research
Health Effects Research
Diagnostic Lab Testing
and Quality Assurance
Program Evaluations
Health Training and
Education
Conservation of
Endangered Species with
Medical Properties
Infrastructure Assessment
and Development
Conservation of
Endangered Species with
Medical Properties
Planning and Forecasting
Consumer
Health and
Safety
Population education
Facility Registration
and Certification
Product Approval
Health Alerts
Promotion of
Preventive Practices
Agriculture Trade
Management
Ensuring a Healthy
Food Chain
Monitor Food and
Drug Supply
Investigative
Operations
Laboratory Operations
Conduct Recalls
Product Inspection
Import/Export
Activities
Facility Inspection
Conduct Compliance
Create Standards &
Guidance
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FHA Line of Business Initiative
Work-in-progress
• Manage Access to Care
• Is beneficiary eligible for this care?
• Manage Population Health and Consumer
Safety
• PH domain.
• Manage the Health Care Business
• Are federal funds spent properly?
• Deliver Health Care Services
• Clinical care
• Conduct Health Care Research
• NIH domain, now includes training.
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Scope of CHI Population Health
Reporting Domain
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Public Health Reporting
Population Health Statistics
Billing Data/Statistics
Institution Health Statistics: not in
scope, but recommended to be similar
to external uses
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Recommendation
• The diversity of terminology needs found lead to the
conclusion that a specific CHI Recommendation is
inappropriate at this time.
• In some circumstances, however, population health
data is identical to clinical data such as reporting of
infectious disease cases to public health departments
or cancer rapid case ascertainment and other
disease registry information to appropriate state
registries. In those cases, the appropriate CHI
domain recommendations for the underlying clinical
data can be used.
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Report Considerations
• The extent to which mapping between two terminologies
can satisfy multiple needs, including population health
reporting
• A description of the forms and complexity of the maps
• Ability of mapped clinical data to relate to longitudinal data
• The problem of using a dual system where part of
population health data is derived from computer mapped
clinical data to a reporting terminology and part reported
as now using human interpretation to the reporting
terminology needs enumeration.
• It is anticipated that the NCVHS, the Board of Scientific
Counselors of the NCHS and The National Library of
Medicine would participate in these studies
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FHA Population Health WG
Data Gathering
Category
Definition / Notes
Emerging Threats
Includes syndromic surveillance
systems, other early event
detection systems and detection of
new agents
Infectious Disease
may subdivide into Air, Food & Water
Borne as work progresses
Chronic Disease
includes registries
Environment
includes air, water, site, occupation,
workplace, injury
Population Health Statistics
includes Vital Records
Patient Safety
adverse event reporting for drugs,
vaccines, medical devices, etc.
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Contact Information
Steven J Steindel, Ph.D.
Senior Advisor, Data Standards and
Vocabulary
Centers for Disease Control and Prevention
Office of the Director
U.S. Department of Health and Human
Services
1600 Clifton Road, MS D-45
Atlanta, GA 30333
(tel) 404-639-7484 (fax) 404-639-7711
[email protected]
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