HL7 Child Health Work Group
Meeting Agenda
The Hilton Walt Disney World
Lake Buena Vista, FL
May 15-17, 2011
Meeting Participants: Andy Spooner, MD, Chris Lehmann, MD, Mike Padula, MD, Willa
Drummond, MD, Jeannie Marcus, MD, Joy Kuhl, Aileen Sedman, MD, Pele Yu, MD, Gaye
Giannone Dolin, MD, Trent Rosenbloom, MD, Anna Orlova (Q1 and Q2 M and Q2T), Don
Mon (Q2), Rob Savage, Gaby Jewell (Q2), Anneke Goosen-Baremas, RN (Q1 and Q2T),
Stank Rankins (Q2T), Floyd Eisenberg, MD (Q2T), Amit Popat (Q2T), Richard Thoreson
(Q2T), Lori Reed-Furquet (Q2T), Janette Heung (Q2T)
Note: Slides and documents referenced are publicly available on the HL7 Child Health Work Group
page on www.hl7.org
Meeting Purpose
Continue progress toward improving data standards for child healthcare in a collaborative and
inclusive way, including developing and fostering application of data standards to influence and
demonstrate meaningful use of certified EHR technology for us in child healthcare
Meeting Objectives
Monday, May 16
 Q1: Identify connections to national activities
 Q1: Raise awareness of work
 Q2: Draft project scope statement for child health profile release 2
 Q2: Plan for progressing with child health profile release 2
 Q3: Plan for progressing with neonatology profile
 Q4: Identify role for our work group in HL7/IHE Health Story consolidation project
Tuesday, May 17
 Q1: Develop agenda for next meeting
 Q2: Understand relationship of quality standards and update on work underway
 Q2: Understand what is involved in creating eMeasures
General Business and HL7 Project Updates
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Joy Kuhl provided info about HL7 Child Health Work Group background and upcoming
work (slides available)
Dr. Lehmann provided update on AAP Child Health Informatics Center (CHIC);
www.aap.org/chic; New eTACC – Electronic Translation of Academy Clinical Content; New
vendor consortium meeting June 2011 on how to deliver AAP content to vendors; Funding
to work with Regional Extension Centers – providing pediatric specific education (slides
available)
Dr. Spooner provided update on CHIPRA EHR Model Format for Children project (slides
available)
Dr. Sedman provided a NACHRI update – CHCA and NACHRI are merging
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May 2011
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Dr. Yu provided an update about the HIMSS Pediatric HIT SIG – they are focusing on
building relationships with HIT vendors
Anna Orlova – Public Health is using our profile as reference for public health profile; want
to know our directions with functional profile R2; want to know about updates to our profile
for their consideration; New Public Health Data Standards Consortium – some successes
in working through IHE
Decisions Made: N/A
EHR Functional Model R2 and Child Health Functional Profile R2
Don Mon from EHR Work Group provided update on status of EHR FM R2 – it will double in size in
terms of functional requirements; early draft or direct care and supportive care just went through
ballot process for open comments; reviewing comments now in preparation of normative ballot later
this year; goal is December for January reconciliation or March for April reconciliation (would need
to have it ready in October)
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Some challenges:
o Is it a gold standard or something more practical? Clinicians want gold standard
and vendors want practical
o Message from HL7 is going to be that you need both compliance with HL7 FM (as
bigger roadmap) and ONC certification
Uptake
o Tracking level of work being adopted by the certification criteria
o International uptake – Australia, Canada and Netherlands
o VA and DOD use
Certification
o No specific plans right now to tie work to certification criteria with all six certification
bodies; However, communicating to CCHIT that R2 is coming
PHR Functional Model DSTU work underway
o Joint HL7/ISO standard – approved as work item
ONC Standards and Interoperability Framework “S&I Framework”
o Accenture to assist with standards harmonization with funding from ONC; Similar to
HITSP process – recently funded – “Support and Coordination” process
o Market driven process … sixth step will be certification
Rob Savage provided update on immunization activities underway in HL7 and CDC – he would like
input from the pediatric community into recently balloted items
The group edited the draft project scope statement for Release 2 of the Child Health Functional
Profile (document available)
Approach
 Revise project schedule to work toward May 2012 ballot
 Update project scope statement and distribute for review
 Develop editing spreadsheets and send to project team for initial review/feedback
 Recruit volunteers for items in project scope statement needing review
 Initial focus on child health edits, but capture input from those who can review in total
Neonatal Profile
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May 2011
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Mike Padula, MD suggested starting point for what could be covered in the neonatology profile.
Discussed level of granularity needed/desired. Need to cross reference with work underway in
Model EHR Format for Children. (slides available)
Suggestions:
 when a detail helps determine something actionable then you need to include it as a
function
 Treat terminology separate
 Move project schedule back
HL7 / IHE Health Story Consolidation Project
Brett Marquard from Lantana Group provided an overview of the project and provided suggestions
on how the Child Health WG could plug in (slides available):
 Review the ballot for familiarity
 What could/should be added for child health in the various structured documents?
 Could we constrain it further for child health use? Could review CCD, as an example, and
suggest a pediatric specific implementation guide as a constraint; Is there a use case for a
pediatric specific CCD?
Working Session – Parking Lot Items
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Neonatology Scope and Next Steps
o Possible phases – start with review of child health profile, how can it be enhanced
without creating new functions
o Parking lot the items that require new functions
o Transport – how to include, where?
 Look at ED profile to see how they address
 Possible separate project – story board and Domain analysis model
 Could be referenced as an example in function descriptions
o What level of detail?
 Could reference sources – see growth chart function as an example of how
we addressed detail in the profile
 Think about what the system needs to be able to do to help you follow
guidelines
AHRQ EHR Model Format Gap Analysis Review – Trent Rosenbloom showed an example
of the results from the project gap analysis review; We need to determine the best time and
way to review the results from this project to incorporate learning back into release 2 of the
profile
Andy provided an overview of his profile review and subsequent discussion with Epic
Discuss possible comments on certification for current public comment opportunity – didn’t
get to this
Look at ED profile – didn’t get to this
Quality Standards and Developing eMeasures
Gaye Giannone Dolin, RN of Lantana Group and Floyd Eisenberg, MD of NQF provided an
update; NQF is starting to receive eMeasures from organizations (CDC submitted 8 proposed
eMeasures related to neonatal hearing screening, 2 accepted with 1 requested to go through
testing first) – perhaps as a strategy to be prepared for meaningful use stage 2 requirements
15 pediatric measures have been retooled within NQF
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May 2011
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Measure authoring tool in development in the Iowa Foundation for Medical Care – will be publicly
available late September with enhanced version late January 2012. Intent is for measure
developers to be able to use the tool.
Two artifacts are needed by measure developers – HQMF and how to represent the report out; In
future want to be able to help developers produce these out of the same tool
Parking Lot Items for NQF
 What is the focus of measures
 Location of value set registry
 Managing essential proprietary vocabularies
 SBIRTS for parameterized reporting
 Education on how to use the tool postponed to September
 Relationship to PQRI
Suggestions
 Select an measure and develop an eMeasure and QRDA to see end-to-end process and
incorporate in the tool; Floyd suggests looking at policy committee for hot items – e.g. care
across settings engaging patient care coordination or longitudinal measures – something
needing to improve over time (hard to get endorsement though if no evidence over time)
 Structured documents is looking at EHDI quality measures as an example for HQMF for
public health reporting and associated QRDA
 Phone call for those interested in involvement
 Authoring tool education would be desired to aid in eMeasure development
 Future expansion of QRDA – have an interest in future development
(slides available)
PARKING LOT
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Need tools to enable pediatricians to participate in the immunization registries –
how can we help?
EHR Model Format for Children gap analysis review
AAP vendor consortium in June
PPI implementation
Connection to public health functional profile in IHE
Labor and delivery summary in IHE
MEETING ACTION ITEMS
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Alliance for Pediatric Quality: Ask to compare AAP advocacy took kit with NACHRI
for common message (Joy)
Connect with Beki on June vendor consortium meeting and opportunity to share
information about available HL7 work (Joy)
Immunization work in CDC – functional requirements for EHR systems underway
(not in HL7); Rob Savage will send us the information to reference as we write the
profile; Add Rob to project team (Joy)
Anna Orlova to help solicit implementers for Child Health Profile R2; Include Anna
in review of draft project scope statement (Joy)
Check on NextGen willingness to list as vendor intending to implement on Child
Health Profile R2 project scope statement (Jeannie)
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May 2011
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Ensure review of current immunization artifacts that went through HL7 ballot –
interested in ideas for additional story boards that are missing; Connect Noor with
Rob (Joy)
Review behavioral health (Joy send to Aileen)
Review child health profile for neonatology mapping (Willa)
Organize neonatology project team (Joy)
Organize child health profile project team (Joy)
We need to help raise awareness of what is available through the consolidation
project for use with regional exchanges; Include in Alliance email (Joy)
Possible education session with HIMSS PHIT SIG, other (?) on consolidation
project; Consider for HIMSS PHIT SIG Agenda (Pele)
Consider publishing EHR CH Profile vs. implemented system – evaluation paper
(Andy and Pele)
Hold the Date: Next In Person Work Group Meeting
January 15-17, 2012 San Antonio, TX
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May 2011
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