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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

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

Jim Jellison, MPH

Deb Bara, MA

topics
Topics

Overview of EHDI

Barriers to EHR – Public Health interoperability

EHDI interoperability capability maturity model

phii s mission
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
early hearing detection intervention ehdi
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)

ehdi clinical workflow
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)

ehdi information exchange context
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

ehdi information exchange standards ihe profiles
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

performance improvement tool
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.

capability maturity model
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

workflow can the ehdi program identify all live birth events in its jurisdiction
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.

policies does your agency have a governance process that guides it projects
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.

benefits to ehdi program
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
thank you
Thank you!

For additional conversation

please contact

Jim Jellison

[email protected]

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