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Assessing State EHDI Programs’ Capability for Standards-Based Health Information Exchange

Assessing State EHDI Programs’ Capability for Standards-Based Health Information Exchange. Jim Jellison, MPH Deb Bara, MA. Topics. Overview of EHDI Barriers to EHR – Public Health interoperability EHDI interoperability capability maturity model. PHII’s Mission.

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Assessing State EHDI Programs’ Capability for Standards-Based Health Information Exchange

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  1. Assessing State EHDI Programs’ Capability for Standards-Based Health Information Exchange Jim Jellison, MPH Deb Bara, MA

  2. Topics Overview of EHDI Barriers to EHR – Public Health interoperability EHDI interoperability capability maturity model

  3. PHII’s Mission To improve health outcomes worldwide by transforming health practitioners’ ability to apply information effectively. We do: • Business process analysis, systems requirements • Evaluations, recommendations • Training

  4. Early Hearing Detection & Intervention (EHDI) • Goal: promote children’s communication and development from birth by detecting hearing loss and intervening. • Universal Newborn Hearing Screening: • 1989: ~3% ; 2011: >98% • Hearing loss prevalence: 1.5 per 1000 screened • Of those screened, 35% LTF/LTD • Providers often lack EHDI knowledge, skills Sources: CDC MMWR (1/30/2004) CDC Annual EHDI Data Reports Shulman, et al. Pediatrics (Suppl., Aug 2010)

  5. EHDI Clinical Workflow No Hearing Loss Pass No Hearing Loss Pass Birth Hearing Screen Audiologic Exam Fail Early Intervention Fail Goal: 1 Month 3 Months 6 Months 2014 Clinical Quality Measure: % screened for hearing loss before hospital discharge Sources: Joint Committee on Infant Hearing (JCIH); Centers for Medicare & Medicaid Services (CMS)

  6. EHDI Information Exchange Context Public Health Hospital Birth Event Birthing Center Birth Registry Birth Event Screening Results EHDI Screening Device Care Plan Pediatrician Primary Care

  7. EHDI Information Exchange Standards (IHE Profiles) Public Health Hospital Newborn Admission Notification Information Birthing Center Birth Registry (Birth Event) Device Enterprise Communication* EHDI Screening Device Early Hearing Care Plan* Pediatrician Primary Care Acknowledgments: IHE QRPH Domain Lisa Nelson (consultant) Lura Daussat (OZ Systems) * To be replaced with EHDI Profile

  8. IHE EHDI Profile (CCD)

  9. Performance Improvement Tool Receiving notices Informatics strategy Sending care plans Data sharing agreements Policies Workflow De-duplicating events Privacy, confidentiality Interoperability SNOMED, LOINC Data & Standards Infrastructure Workforce IT Architecture HL7 IHE HIE Adapted from C4ISR AWG Architectures Working Group, Department of Defense. 1998. Levels of Information Systems Interoperability (LISI). Washington, D.C.: United States Department of Defense.

  10. Capability Maturity Model Level 5 Optimized Use evaluation results to improve Level 4 Measured Evaluation of procedures, processes Level 3 Defined Routine processes, documented procedures; Established governance, policies Level 2 Managed Repeat early successes; Begin to establish processes Level 1 Initial Isolated, ad-hoc efforts; Individual heroics Adapted from the Capability Maturity Model developed by the Software Engineering Institute at Carnegie Mellon University.Capability Maturity Model is registered service mark of Carnegie Mellon University. Level 0 None No awareness or efforts

  11. WorkflowCan the EHDI program identify all live birth events in its jurisdiction? Level 5 Optimized Use of evaluation findings to improve live birth event identification process. Level 4 Measured Evaluation of automated live birth event identification process. Automated approaches; Consistently good results; Few unresolved duplicate birth events. Level 3 Defined Combine manual, automated approaches; Inconsistent results; Some unresolved duplicates. Level 2 Managed Level 1 Initial Manual; Inconsistent results; Many unresolved duplicate birth events. Level 0 None Unable to conduct these activities.

  12. PoliciesDoes your agency have a governance process that guides IT projects? Agency uses evaluation findings to improve governance of information systems development. Level 5 Optimized Agency has established such a governance process and evaluates how well it guides IT projects towards agency objectives. Level 4 Measured Agency has established such a governance process and exercises it regularly. Level 3 Defined Agency has made sustained attempts at governing information system projects. Level 2 Managed Agency has made isolated, ad-hoc efforts to govern information systems projects. Level 1 Initial Level 0 None No such governance structure.

  13. Benefits to EHDI Program • Better understanding of current interoperability readiness • Evidence for additional resources • More collaboration between EHDI, IT, agency leadership • More informed national strategy for capacity building

  14. Thank you! For additional conversation please contact Jim Jellison jjellison@taskforce.org

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