HL7 Immunization User Group Monthly Meeting June 13, 2019 2:00 PM - - PowerPoint PPT Presentation

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HL7 Immunization User Group Monthly Meeting June 13, 2019 2:00 PM - - PowerPoint PPT Presentation

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HL7 Immunization User Group Monthly Meeting June 13, 2019 2:00 PM ET Agenda Welcome Poll: Which perspective do you primarily identify yourself with? Updates National Meeting Updates SISC Update Discussion Common HL7

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HL7 Immunization User Group

Monthly Meeting June 13, 2019 2:00 PM ET

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Agenda

  • Welcome
  • Poll: Which perspective do you primarily identify yourself with?
  • Updates
  • National Meeting Updates
  • SISC Update
  • Discussion
  • Common HL7 Issues and Resolutions Identified During Onboarding
  • We will meet in July, but August is cancelled
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National Meeting Updates

Tracy Little

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SISC Update

Heather Patrick

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Common HL7 Issues and Resolutions Identified During Onboarding

Kevin Snow

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  • What data quality issues are discoverable in the HL7

message?

  • What can we do with the HL7 to prevent bad data in…

without rejecting good data?

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Patient – Identifiers (MR, SS, etc.)

  • Identifiers with placeholder text or in the wrong format

PID|1||87542982^^^MyEHR^MR~5555555555555^^^MA^MCD~222445555SS^^^SS^SSA|

  • Alternate identifiers with mismatched identifier type
  • A PI or MR type ID that looks like an SS or MA.

PID|1||200224455^^^MyEHR^MR~43259986543^^^MA^MCD~200224455^^^SS^SSA|

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Patient – Identifiers (MR, SS, etc.)

Identify:

  • Alternate identifiers with suspicious formats such as 111111111 or

123456789

  • Identifiers with invalid values such as NONE
  • Identifiers with mismatched identifier type codes such as a MA or SS being

sent as an MR

  • Ask the vendor and provider: Which identifiers are required to be entered in

the EHR?

Resolve:

  • Implement business rules during message processing to flag invalid ID formats
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Patient – Name (Last, First, and Middle)

  • Placeholder text in name fields. This may be more prevalent in

responsible person name fields.

  • Patient: Tracy None Little

PID|1||87542982^^^MyEHR^MR||LITTLE^TRACY^NONE^^^^L|…

  • Also applies to Responsible Person names: Tracy Carole None

NK1|1||NONE^TRACY^^^^^L|MTH^MOTHER^HL70063|… NK1|1||MOTHER^TRACY^^^^^L|MTH^MOTHER^HL70063|…

  • Placeholder text when patient does not yet have a legal name.
  • Baby Boy Little

PID|1||87542456^^^MyEHR^MR||LITTLE^BABY^BOY^^^^|…

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Patient – Name (Last, First, and Middle)

Identify

  • Suspect values such as ‘None’ or ‘Test’ ‘Mother’ or ‘Blank’
  • Ask the vendor and provider: What naming convention is used for baby

names?

Resolve

  • Implement business rules to prevent suspected bad data from importing.
  • Patient first or last name is ‘baby’ or ‘none’
  • Patient first or last name contains a numerical value
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Patient – Mothers Maiden Name

  • Placeholder text in mother’s maiden name (last) field

PID|1||87542982^^^MyEHR^MR||LITTLE^TRACY^^^^^L|UNKNOWN^^^^^^M|…

  • Placeholder text in mother’s maiden name (first, middle) field

PID|1||87542982^^^MyEHR^MR||LITTLE^TRACY^^^^^L|SMITH^UNKNOWN^UNK NOWN^^^^M|…

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Patient – Mothers Maiden Name

Identify

  • Similar to patient name issues; is placeholder text being sent?
  • Ask the vendor and provider: Is the EHR requiring a full name when the HL7

IG is only asking for the maiden last name?

Resolve

  • Clarify submission requirements (not all CDC Endorsed Data Elements are

required per the HL7 IG) to ensure that providers are not required to enter something even if unknown.

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Patient - Address

  • Invalid data in patient address

PID|1||432155^^^dcs^MR||Brickowski^Emmett^^^^^L|Brickowski^Sally^^^ ^^M |20110411|M|||9684 Duplo Drive^^8005551212^WI^54000^^L||…

  • Placeholder text in patient address

PID|1||432155^^^dcs^MR||Brickowski^Emmett^^^^^L|Brickowski^Sally^^^ ^^M |20110411|M|||ADDRESS UNKNOWN^^Madison^WI^54000^^L||…

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Patient - Address

Identify

  • Street address of ‘none’ ‘blank’ ‘n/a’ ‘temp’ or ‘unknown’
  • Street address is empty or contains invalid data

Resolve

  • If your IIS requires a patient address is sent, ensure that EHRs and providers

know the repercussions of sending placeholder text.

  • Have a plan for providers when they want to report immunizations, but no

viable address for the patient.

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Patient – Race/Ethnicity

  • Invalid (or old) codes for patient race or patient ethnicity

PID|1||432155^^^dcs^MR||Patient^Johnny^New^^^^L|Lastname^Sally^^^^^ M |20110411|M||I^American Indian or Alaska Native^HL70005|123 Any St^^Somewhere^WI^54000^^L||…

  • Incorrect codes for patient race or patient ethnicity

PID|1||432155^^^dcs^MR||Patient^Johnny^New^^^^L|Lastname^Sally^^^^^ M |20110411|M||1002-5^Native American^HL70005|123 Any St^^Somewhere^WI^54000^^L||||||||||||N^not Hispanic or Latino^HL70189|…

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Patient – Race/Ethnicity

Identify

  • Correct code sets are being used
  • Correct mapping of race to PID-10 and ethnicity to PID-22.
  • Ask the vendor and provider: Which code sets are set up to send in the EHR?

Ensure that your IIS is validating the code during processing.

Resolve

  • Communicate correct code sets to vendors
  • Implement business rules that do not permit invalid codes to be imported
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Vaccination – Administration Date

  • Administration Date is illogical

RXA|0|1|20220113||48^HIB PRP-T^CVX|0.5|mL^^UCUM||00^New admin^NIP001|…

  • Administration Date is unlikely

PID|1||432155^^^dcs^MR||Patient^Johnny^New^^^^L|Lastname^Sally^^ ^^^M |20110411|… ORC|… RXA|0|1|20120113||165^HPV9^CVX|0.5|mL^^UCUM||00^New admin^NIP001|^Sticker^Nurse^^^^^^^^^^^^^^^^^^RN|^^^DCS_DC||||32k 2a|20130309|PMC^sanofi^MVX|||CP|A

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Vaccination – Administration Date

Identify

  • Find illogical or improbably dates in IIS data.
  • Administration date is in the future or too far in the past.
  • Administration date is on a suspicious date such as January 1 or there are spikes of

historical doses every month on the 1st or 15th.

  • Ask the vendor and provider: How are historical immunizations entered when

the exact month or day is unknown?

Resolve

  • Implement business rules to ensure that immunizations with a date prior to

the patient’s date of birth are rejected.

  • Advise providers on how to manage historical immunizations when the

month/day is unknown.

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Vaccination – Administered Code (CVX, NDC)

  • Administered doses reported with the unspecified CVX code

RXA|0|1|20190113||137^HPV Unspecified^CVX|0.5|mL^^UCUM||00^New admin^NIP001|…

  • Administered doses with mismatched CVX and NDC codes

RXA|0|1|20190113||48^HIB PRP- T^CVX~00006409301^HepB^NDC|0.5|mL^^UCUM||00^New admin^NIP001|…

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Vaccination – Administered Code (CVX, NDC)

Identify

  • Unspecified vaccine codes sent with a dose marked as administered (RXA-9 is

00)

  • Mismatched CVX and NDC codes in the same RXA segment

Resolve

  • Implement business rules to validate NDC to CVX
  • Follow up with the vendor and provider to ensure that CVX codes are current

in EHR.

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Vaccination – Lot Number

  • Extra characters appended to lot numbers to identify stock

(private/public)

RXA|0|1|20120113||165^HPV9^CVX|0.5|mL^^UCUM||00^New admin^NIP001|^Sticker^Nurse^^^^^^^^^^^^^^^^^^RN|^^^MAIN ST CLINIC||||32k2a-PRIVATE|20130309|PMC^sanofi^MVX|||CP|A

  • Placeholder text in lot number field

RXA|0|1|20120113||165^HPV9^CVX|0.5|mL^^UCUM||00^New admin^NIP001|^Sticker^Nurse^^^^^^^^^^^^^^^^^^RN|^^^MAIN ST CLINIC||||2222222|20130309|PMC^sanofi^MVX|||CP|A

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Vaccination – Lot Number

Identify

  • Extra characters in the lot number field, such as ‘VFC’ or ‘private’
  • Monitor during ongoing submission for issues with inventory deduction
  • Ask vendor and provider: Are lot numbers manually typed into the patient

record or selected from a drop down?

  • Resolve
  • Send an acknowledgment to the provider.
  • Consider business rules that review the format of lot numbers, looking for

patterns or suspicious characters.

  • Prevent or reduce occurrence of this issue by not allowing manual entry of lot

numbers to the EHR.

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Vaccination – Route/Site

  • Including Site but not Route

RXR| |RT^Right Thigh^HL70163

  • Using the correct codes

RXR|IM^Intramuscular^HL70162|RT^Right Thigh^HL70163

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Vaccination – Route/Site

Identify

  • Missing site or route data
  • Use of older code sets

Resolve

  • Follow up with vendor and provider to ensure that code sets are correct in

EHR

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What are some of your favorite ways to use HL7 to identify incoming data quality issues?

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Next Meeting

July 11, 2019 2:00 pm ET / 11:00 am PT

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More Information

  • Web Links
  • Subscribe to immunization group

http://www.hl7.org/participate/UserGroups.cfm?UserGroup=Immunization

  • Public User Group Wiki

http://www.hl7.org/special/committees/iug/index.cfm

  • Private User Group Wiki

http://iugwiki.hl7.org/

  • HL7 Press Release

http://www.hl7.org/documentcenter/public_temp_F760602A-1C23-BA17- 0C0D326E635471F9/pressreleases/HL7_PRESS_20140402.pdf

  • AIRA Press Release

http://www.immregistries.org/events/2014/04/10/hl7-immunization-user-group

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Contact Information

If you have any questions or comments:

  • Kim Salisbury-Keith Kim.SalisburyKeith@health.ri.gov
  • Nathan Bunker nbunker@immregistries.org
  • Kevin Snow ksnow@envisiontechnology.com
  • Danny Wise Danny.Wise@allscripts.com

Thank you!