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HL7

The HL7 messaging standard, version two that was implemented by most vendors and public health agencies did not resolve all systems’ interoperability problems. Design and tool implementation for automated machine-testing messages may resolve many of those problems. This task also has critical importance for rapid deployment of electronic public health systems.

Objective

This document describes the Public Health Information Network (PHIN) efforts on the development of the MQF, a flexible framework of services and utilities designed to assist public health partners with preparing and communicating quality, standard electronic messages.

Referenced File
Submitted by teresa.hamby@d… on

The HL7 messaging standard, version two that was implemented by most vendors and public health agencies did not resolve all systems’ interoperability problems. Design and tool implementation for automated machine-testing messages may resolve many of those problems. This task also has critical importance for rapid deployment of electronic public health systems.

 

Objective

This document describes the Public Health Information Network efforts on the development of the messaging quality framework, a flexible framework of services and utilities designed to assist public health partners with preparing and communicating quality, standard electronic messages.

 

Referenced File
Submitted by hparton on

Standard vocabulary facilitates the routing and filtering of laboratory data to various public health programs. In 2008, Council of State and Territorial Epidemiologists (CSTE) developed 67 Technical Implementation Guides (TIGs) that accompany each condition and contain standard codes for NNC reporting. Those TIGs were reviewed by a public health subject matter expert panel (SMEP), in May 2010, consisting of members of the CDC CSTE Laboratory and PHIN Vocabulary and Messaging Communities of Practice Program, and representatives from the Regenstrief Institute and the International Health Terminology Standards Development Organization.

Objective

Electronic laboratory reporting (ELR) has a key role in public health case reporting and case notification. This paper will discuss the current status, problems, and solutions in a vocabulary support of nationally notifiable conditions (NNC) reporting.

Referenced File
Submitted by Magou on

The Influenza Division (ID) in the Centers for Disease Control and Prevention (CDC) maintains the WHO/NREVSS surveillance system, a network of laboratories in the U.S. that report influenza testing results. This system has seen many changes during the past 40 years, especially since the 2009 H1N1 pandemic. This was due in large part to increased adoption of HL7 messaging via PHLIP. PHLIP data is detailed, standardized influenza testing information, reported in near real-time. The data received through this and other report methods is published online in national and regional aggregate form in FluView, a weekly surveillance report prepared by CDC.

Objective

Describe the changes to the World Health Organization/National Respiratory and Enteric Virus Surveillance System (WHO/NREVSS) influenza surveillance system over time, with a focus on the Public Health Laboratory Interoperability Project (PHLIP) and how it has influenced the system

Submitted by elamb on

Domains go through phases of existence, and the electronic disease surveillance domain is no different. This domain has gone from an experimental phase, where initial prototyping and research tried to define what was possible, to a utility phase where the focus was on determining what tools and data were solving problems for users, to an integration phase where disparate systems that solve individual problems are tied together to solve larger, more complex problems or solve existing problems more efficiently. With the integration phase comes the desire to standardize on many aspects of the problem across these tools, data sets, and organizations. This desire to standardize is based on the assumption that if all parties are using similar language or technology then it will be easier for users and developers to move them from one place to another.

Normally the challenge to the domain is deciding on a vocabulary or technology that allows seamless transitions between all involved. The disease surveillance domain has accomplished this by trying to use some existing standards, such as HL7, and trying to develop some of their own, such as chief complaint-based syndrome definitions. However, the standards that are commonly discussed in this domain are easily misunderstood. These misunderstandings are predominantly a communication and/or educational issue, but they do cause problems in the disease surveillance domain. With the increased use of these standards due to meaningful use initiatives, these problems will continue to grow and be repeated without improved understanding and better communication about standards.

 

Objective

This talk will point out the inconsistencies and misunderstandings of the word "standard". Specifically, it will discuss HL7, syndrome definitions, analytical algorithms, and disease surveillance systems.

Referenced File
Submitted by elamb on

Medical surveillance in the military can be improved through the use of clinical laboratory results collected within the Military Health System. This presentation describes an effort to establish Electronic Laboratory Reporting in the military using existing Health Level 7 (HL7) messages. HL7 data is being evaluated for data integrity, completeness, reliability and validity. In addition, initial efforts to evaluate, standardize, and use this data to support investigations of interest over the past year are presented.

 

Objective

This presentation describes the HL7 clinical lab results dataset and how it can and has been used for medical surveillance in the military.

Referenced File
Submitted by elamb on

Reporting allows for the collection of statistics that show how often disease occurs, which helps researchers identify disease trends and track disease outbreaks. U.S. Navy has a modified list of reportable medical events to accommodate for deployment limiting functions. Reports on all reportable events are submitted to the Naval Disease Reporting System (NDRS). Medical event surveillance is particularly important in the military populations where medical events can have mission-degrading implications and affect troop strength.

Objective

The purpose of the study was to determine whether, through the use of existing electronic laboratory and clinical care databases, it is possible to capture the majority of reportable disease cases, and remove the burden of case finding from the commands through NDRS. Establishment of a more efficient reporting system was proposed to provide more timely disease reporting and aid in active disease surveillance.

Referenced File
Submitted by elamb on

Health care processes consume increasing volumes of digital data. However, creating and leveraging high quality integrated health data is challenging because large-scale health data derives from systems where data is captured from varying workflows, yielding varying data quality, potentially limiting its utility for various uses, including population health. To ensure accurate results, it’s important to assess the data quality for the particular use. Examples of sub-optimal health data quality abound: accuracy varies for medication and diagnostic data in hospital discharge and claims data; electronic laboratory data used to identify notifiable public-health cases shows varying levels of completeness across data sources; data timeliness has been found to vary across different data sources. Given that there is clear increasing focus on large health data sources; there are known data quality issues that hinder the utility of such data; and there is a paucity of medical literature describing approaches for evaluating these issues across integrated health data sources, we hypothesize that novel methods for ongoing monitoring of data quality in rapidly growing large health data sets, including surveillance data, will improve the accuracy and overall utility of these data.

 

Objective

We describe how entropy, a key information measure, can be used to monitor the characteristics of chief complaints in an operational surveillance system.

Submitted by hparton on
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