HL7 Immunization User Group Monthly Meeting September 12, 2019 - - PowerPoint PPT Presentation

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HL7 Immunization User Group Monthly Meeting September 12, 2019 - - PowerPoint PPT Presentation

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HL7 Immunization User Group Monthly Meeting September 12, 2019 2:00 PM ET Agenda Welcome Poll: Which perspective do you primarily identify yourself with? Updates SISC Update New Sub/Ack Measures for NDC National Meeting

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HL7 Immunization User Group

Monthly Meeting September 12, 2019 2:00 PM ET

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Agenda

  • Welcome
  • Poll: Which perspective do you primarily identify yourself with?
  • Updates
  • SISC Update
  • New Sub/Ack Measures for NDC
  • National Meeting
  • Review of HL7 sessions of interest
  • AART Clinics
  • HL7 Balloting
  • Immunization CDS Profile IG
  • HL7 FAQ
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SISC Update

Heather Patrick

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New Sub/Ack Measures for NDC

Eric Larson

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Content Area

Transport Submission / Acknowledgement Query / Response CDS Data Quality

Testing & Discovery Assessment Validation Testing & Discovery Assessment Validation Testing & Discovery Assessment Validation Testing & Discovery Assessment Testing & Discovery

1 2 3

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Content Area

Transport Submission / Acknowledgement Query / Response CDS Data Quality

Testing & Discovery Assessment Validation Testing & Discovery Assessment Validation Testing & Discovery Assessment Validation Testing & Discovery Assessment Testing & Discovery

1 2 3

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Transport

  • 3 Measures

Submission/ ACK

  • 14 Measures

Query/ Response

  • 8 Measures

CDSi

  • 12 Measures

Data Quality

  • Data at Rest - #TBD
  • Incoming/Ongoing Data – #TBD

Measures that Make Up Assessment Content Areas

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Transport

  • 3 Measures

Submission/ ACK

  • 14 Measures

Query/ Response

  • 8 Measures

CDSi

  • 12 Measures

Data Quality

  • Data at Rest - #TBD
  • Incoming/Ongoing Data – #TBD

Measures that Make Up Assessment Content Areas

+ 2 New Measures for NDC

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Two New Measures

15)The IIS processes an administered vaccine using the preferred NDC format.

  • This will include Unit of Use and Unit of Sale test cases in the

community preferred 11 digits with hyphens format

16)The IIS processes an administered vaccine using alternative NDC formats.

  • This will include Unit of Use and Unit of Sale test cases in known

(and standard) alternative NDC formats (i.e., 10 digits w/ hyphens; 11 digits w/o hyphens)

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How will this impact Validation?

  • It won’t change anything immediately
  • Validation will remain as is for now
  • Measures have to be in Assessment for 3 quarters before

they can be considered for Validation

  • After 3 quarters, they can be moved to Validation through

the same public comment and board approval process as Assessment

  • Realistically, we’d be looking at Q1 2021 to recommend

moving these measures into Validation

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National Meeting

Nathan Bunker & Tracy Little

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Interoperability Presentations

  • Quick review of presentations from the National Meeting
  • Select a few that you might have missed and want to hear
  • Please rate each one:
  • Yes, please cover this in a future HL7 User Group Meeting
  • Maybe
  • Not interested, we don’t need to cover this in future meetings
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#1 Ask EHR Experts about IIS & Electronic Health Records

  • Author:
  • Danny Wise, Allscripts
  • Kristin Glaza, Cerner
  • Why tracking vaccines is

important

  • Provider experience
  • Frequently misunderstood

concepts

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#2 Measurement & Improvement: From Transport to Decision Support, All Your Questions Answered

  • Authors:
  • Mary Beth Kurilo, AIRA
  • Eric Larson, AIRA
  • Introduction and overview to the

AIRA Measurement and Improvement project

  • Overview of the project
  • Success and challenges
  • Frequently asked questions
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#3 From Muddled to Methodized: Onboarding in Minnesota

  • Author: Angie Felt, MN
  • The steps and process that MIIC

created in order to improve their

  • nboarding
  • Increased the number of providers

connected

  • Reduced their average monthly queue
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#4 Colorado's Success with AIRA's Onboarding Consensus-Based Recommendations

  • Authors:
  • Darrin Rosebrook, AMCI
  • Kim Gulliver, CO
  • Showed details on

improvements to onboarding process

  • Reduced overall project

timelines

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#5 Connecticut Onboarding: Starting All Over Again After a Migration

  • Authors:
  • Nancy Sharova, CT
  • Alejandra Arias, CT
  • Covered work towards re-
  • nboarding providers to new

system

  • New system went live Sept 2018
  • Working towards onboarding goal

by June 2020

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#6 Bidirectional Onboarding: A Beginner's Guide to Success

  • Authors:
  • John Robinson, Philadelphia
  • Went over basic concepts:
  • Bidirectional Interface
  • Testing Plan
  • Communication
  • Known Issues
  • Problems of the Future
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#7 Lessons Learned Exploring Advanced Analysis of HL7 Log Data

  • Authors:
  • Kevin Snow, Envision
  • Steve Murchie, Envision
  • Using generally available

software products:

  • Elastic
  • Power BI
  • Get more information out of

your current data

  • “Big Data”
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#8 Improving IIS HL7 Web Service Performance in New York City

  • Author:
  • Monica Sull, NYC
  • Performance improvements
  • Redundancy
  • Load balancing
  • Database indexing
  • Increase threads between servers
  • Reduced response time
  • Traffic: from 3.5 to 4.0 million
  • Response: from 5.71s to 2.62s
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#9 Something Old and Something New: Understanding HL7 Immunization Standards

  • Author:
  • Heather Patrick, CDC
  • Review of Frequently Asked Questions
  • Query/Response
  • HL7 Acks
  • Update on HL7 2.8.2
  • What changed
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AART Clinics

  • 33 AART Clinics held at the AIRA National

Meeting in August

  • Positive feedback from attendees
  • Fielding many follow up questions since the AART

Clinics

  • Reaching out to IIS teams that did not attend to

schedule a virtual AART Clinic

  • Planning for AART Clinics at the 2020 AIRA National

Meeting

  • What can we do to enhance the AART Clinic experience?
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HL7 Balloting

Immunization CDS Profile IG

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Immunization Decision Support Forecast Implementation Guide STU 1

  • http://build.fhir.org/ig/HL7/ImmunizationFHIRDS/index.html
  • Ballot #1
  • January 2018
  • Ballot #2
  • September 2019
  • FHIR release 4
  • Standard for Trial Use (STU)
  • Votes: 46 Affirmative, 5 Negative
  • 4 Negatives recommended use CDS Hooks in preference to a FHIR operation
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Use Case for EHR Query to IIS

  • Focus is on

green area only

  • Standardizes

custom web services being used today

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What is next?

  • Ballot comments will be

reviewed initially

  • Public Health – Thursday Q1
  • Connectathon Sept 2019
  • Vaccine Forecast Analyzer ?
  • Lone Star Forecaster ?
  • Step Into CDS for Immunizations ?
  • Integrate with Touchstone ?
  • Integrate with CDS Hooks ?
  • Initial implementors:
  • NIST Forecast Immunization Tester

(FITS)

  • Other vendors participating in the

group

  • Ballot #3
  • Support added for special

conditions

  • Join our group and help with the

project!

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HL7 FAQ

CDC-AIRA Technical Assistance Team

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Disagreement of NDC and CVX

  • Both CVX and NDC can be transmitted in RXA-5
  • CE data type allows two representations of the same concept
  • One concept may be more specific (NDC is more specific than CVX)
  • Receiver may read one or both of the values
  • IIS should support both CVX and NDC
  • CVX support is required by the IG
  • NDC support is needed to support certified systems
  • What if the codes don’t agree?
  • Understanding the correct code is critical for IIS
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Disagreement of NDC and CVX

  • Two resources that might help:
  • https://repository.immregistries.org/resource/iis-functional-guide/
  • https://repository.immregistries.org/resource/iis-data-quality-practices-to-

monitor-and-evaluate-data-at-rest/

  • Ideal solution
  • IIS should recognize conflicts between values
  • IIS may return an error or warning about situation
  • IIS decides on what data should or should not be stored
  • IIS should have data quality process to engage with submitter and resolve
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NIST Tool Warnings

  • Will generate warnings for messages
  • Even for NIST example messages!
  • Warnings indicates:
  • Areas that the tool cannot verify that will

require additional testing to ensure conformance

  • Especially for RE fields
  • Warnings are expected:
  • Test messages sent by EHR systems
  • Production data from submitters

https://hl7v2-iz-r1.5-testing.nist.gov/iztool/#/cf

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Disease with Presumed Immunity & OBX-14

  • When sending history of Varicella infection
  • OBX|1|CE|59784-9^Disease with presumed immunity ^LN|1|38907003^HISTORY

OF VARICELLA INFECTION^SCT||||||F|||20090412<CR>

  • What do you send in OBX-14 Date/Time of Observation?
  • Recent SISC decision:
  • “If the appropriate value is not known, OBX-14 should remain empty – it is an RE field

and is not required in every message instance”

  • But what if only YYYYMM is known?
  • Option 1: Send OBX-14 as blank
  • Option 2: Send only YYYYMM in OBX-14
  • This is a conformance violation but should not prevent message from being processed
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Next Meeting

October 10, 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!