HL7 Child Health
Work Group
May 15-17, 2011
HL7 Work Group Meeting
Lake Buena Vista, FL
Agenda
HL7 Child Health Work Group
 Who We Are
 What We Do and Why
 What’s Next
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Who We Are
HL7 Child Health Work Group
Founded:
Leadership:
2003
David Classen, MD, Gaye Giannone Dolin, RN,
Andy Spooner, MD and Feliciano Yu, MD
Participation: Primarily CMIOs, physicians, medical informatics
experts and vendor representatives
Distribution: 100+ previously on email; listserv unknown
Operations: One in person meeting and two webcast meetings
in conjunction with HL7 work group meetings;
Monthly calls and other calls and webcasts as
needed
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
What We Do
 Functional Data Standards
 Standards for EHR systems include critical child health functions
 Published EHR system standards for general pediatrics
 Work was baseline for CCHIT child health certification criteria, other
 Terminology Data Standards
 Explored improving terminology systems for pediatrics using AAP policy
statements (e.g. SNOMED)
 Funding not available to support further work
 Messaging Data Standards
 Created immunization activity diagrams and story boards – now part of
HL7 messaging standards
 Provided incubation and leadership in HL7 to develop standard for
reporting quality measure data – Quality Reporting Document Architecture
using HL7 CDA
 Provided support to create standards-based neonatal care report using
HL7 CDA
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Why
 Improve data standards for health care



Build pediatric consensus on new data standards
Maintain broad representation and participation in HL7
initiatives on behalf of child health care
Participate in relevant national HIT data standards public
comment periods on behalf of child health care
 Influence adoption of pediatric requirements

Impact vendor and provider awareness and adoption of
adoption of pediatric standards
 Earn commitment from pediatric
stakeholders

Secure support and leadership for efforts
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
What’s Next
 EHR Functional Model Release 2
 Neonatology Functional Profile for EHR
Systems
 Child Health Functional Profile Release 2
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Functional Standards:
Relationships of Artifacts
EHR System Functional Model
• General Functional Requirements for all EHR Systems
Child Health Functional Profile for EHR
Systems
• EHR-S FM + Unique Child Health Criteria and Constraints
Derived Functional Profiles for EHR
Systems
• EHR-S FM + CHFP + Unique domain criteria and constraints
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Example
Edits and Additions to EHR FM
Manage
Immunization
Administration
Statement: Capture and maintain discrete data concerning
immunizations given to a patient including date administered, type,
manufacturer, lot number, and any allergic or adverse reactions.
Facilitate the interaction with an immunization registry to allow
maintenance of a patient’s immunization history.
1. The system SHALL provide the ability to recommend required
immunizations, and when they are due, during an encounter based
on widely accepted immunization schedules.
Description: During an encounter, recommendations based on
accepted immunization schedules are presented to the provider.
Allergen and adverse reaction histories are checked prior to giving
the immunization. If an immunization is administered, discrete data
elements associated with the immunization including date, type,
manufacturer and lot number are recorded. Any new adverse or
allergic reactions are noted. If required, a report is made to the
public health immunization registry.
2. The system SHALL provide the ability to recommend required
immunizations based on patient risk factors.
Function:
“Manage
Immunization
Administration”
“Capture and
maintain discrete
data concerning
immunizations…”
Criteria
requested by
Child
foror
3. The system SHALL perform
checkingHealth
for potential adverse
allergic reactions for all immunizations when they are about to be
given.
original model
now
4. The system SHALL provide
the abilitystandard
to capture immunization
administration details, including date, type, lot number and
manufacturer.
5. The system SHALL provide the ability to capture other clinical
data pertinent to the immunization administration (e.g. vital signs,
adverse reactions).
6. The system SHALL record as discrete data elements data
associated with any immunization.
Edits in
7. The system SHOULD provide the
ability to associate
standard
RED
for CH
codes with discrete data elements associated with an immunization.
Profile
8. The system SHALL provide the ability to update the immunization
schedule.
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Connect With Us
 www.hl7.org for Child Health Listserv
 Monthly Conference Calls
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Contact Information
Joy Kuhl
Principal
Optimal Accords, LLC
joy@optimalaccords.com
Offiice: (818) 308-7063
Mobile: (818) 817-1050
Administrative Co Chair, HL7 Child Health Work Group
On behalf of Alliance for Pediatric Quality
AAP, ABP, CHCA & NACHRI
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
DISCUSSION, NEXT STEPS
Alliance for Pediatric Quality
Common goals:
HIT works for children
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Alliance Strategy
 Work for consensus and speak with one voice for
pediatric quality and health information technology.
 Endorse and promote projects that advance our
objectives for quality and health information
technology in children’s health care.
 Convene stakeholders in children’s health care on
key quality and health information technology issues.
 Advocate for policy, standards, systems, and
products that will improve the quality of children’s
health care.
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Why is this important?
Numerous Initiatives Underway to Support National Goals
for Adoption and Interoperability of EHR technology
Problem: Children are nearly one third of
the population. They receive care through HIT
in a variety of settings. National efforts are
largely adult-focused; Pediatric efforts for
influence are sometimes isolated and
duplicative.
Opportunity: Work together as pediatric HIT
community with one strong voice to influence
national initiatives and ensure needs of child
healthcare are addressed.
www.hl7.org
| HL7 Child Health
Work Group | February
22, 2011
Strategy for Influence
Alliance for Pediatric Quality
Support work, convene, build consensus, endorse and advocate
Identify and
Respond to
Opportunities
Participants
in
Pediatric
Healthcare
Information
Technology
Community
Identify
Requirements
Health Level
Seven (HL7) Child
Health Work Group
AAP Child Health
Informatics Center
and COCIT
HIMSS Pediatric
Group
NACHRI Pediatric
Advisory Council
CHCA CIO and
CMIO Forums and
Special Projects
www.hl7.org
Set National Agenda
HHS: Coordinator
IFR
Develop and Pilot
Standards
Adopt
Standards and
other
Requirements
for Meaningful
Use
HL7, SNOMED…
Integrating the
Healthcare Enterprise
NHINS, Projects,
Collaboratives
Health Information
Technology
vendors
NQF, CMS
Vendor Consortia
Harmonize
ONC, other tbd
Child health
practitioners,
clinicians
and hospitals
Certify Products
ATCB
| HL7 Child Health
Work Group | February
Desired
Outcomes
Support safe care
for children
Enable pediatric
performance
measurement by
improving
interchange of
standardized
information
Reduce system
implementation
costs due to
duplication and
customization
Support
achievement of
meaningful use of
EHR technology in
pediatrics
22, 2011
An Example
AAP
HL7 Child
Health
Published
EMR
Position
Papers
Developed
Pediatric
EMR
Functions
HL7
CCHIT
Published
Pediatric
EMR
Functional
Model
Standard
Influenced
EMR Vendor
Certification
Criteria
Alliance Coordination, Support and
Endorsement
www.hl7.org
| HL7 Child Health
Vendor Compliance &
Certification;
Provider
Adoption
Work Group | February
22, 2011