Short Description

The MedMorph/FluSurv-NET/Health Care Surveys(HCS) Connectathon track aims to test the FluSurv-NET and HCS Content Implementation Guides (IGs) leveraging the MedMorph Reference Architecture.

Currently the FluSurv-NET content implementation guide is not developed, however the plan is to use the Electronic Case Reporting (eCR) FHIR IG since the eCR FHIR IG has all the needed data elements for FluSurv-NET.

For HCS, the following HL7.FHIR.US.HEALTH-CARE-SURVEYS-REPORTING\Health Care Surveys Content IG Home - FHIR v4.0.1 IG would be used.

Long Description

FluSurv-NET and HCS intend to test established and developing FHIR components created by Centers for Disease Control (CDC) / Public Health, and similarly the FHIR components used by clinical partners for public health reporting using MedMorph.

The track also intends to raise awareness of the infrastructure being developed both by the clinical organizations and the CDC / Public Health for public health surveillance.

The track focus will be on the use of identified content in the FluSurv-NET and HCS IGs for automated transmission and submission of Data from Electronic Health Records (EHRs) to Public Health Agencies (PHAs), CDC Data Repositories using the MedMorph Reference Architecture.

The Track organizers will provide the first participants who volunteer to perform testing with access to a simulated environment consisting of a FHIR server populated with fictitious data and a “Backend Submitter Application” configured to the same target “Public Health Data Receiver platform”.

A few objectives of this track are:

  • Test FluSurv-NET using the Electronic Case Reporting IG:

    • The track will focus on transmission of FluSurv-NET case information from hospitals to FluSurv-NET sites and to CDC.

  • Test the Health Care Surveys Reporting IG:

    • The track will focus on the National Hospital Care Survey (NHCS) and National Ambulatory Medical Care Survey (NAMCS) data to be extracted from EHRs and/or clinical data repositories via FHIR and APIs and sent to National Center for Health Statistics (NCHS)/a system hosted at the federal level.

  • Track testing will address the gaps in workflow and triggers, and FluSurv-NET and HCS Content IGs along with other applicable existing HL7 FHIR Implementation Guides to address the public health information needs.

  • Gather input that helps inform the architecture, use cases, and technical implementation approaches being developed by PHAs/CDC and the clinical sites.

  • Identify any gaps or errors in proposed solutions.

  • Explore harmonization with related projects.

  • Lessons Learned for Future Connectathon testing.
  • Record JIRA Tickets to capture potential refinements to the IGs utilized in this track.


Test Implementation Guides.

Related Tracks?

Other Public Health tracks / Helios Accelerator

Call for participants

Providers/EHR vendors and Health Information Exchanges (HIEs) who are interested in creating/submitting bundles conforming to either the HCS or FluSurv-NET IGs.

The CDC is planning to participate as the receiving endpoint.

Track Prerequisites

The ability to send bundles conforming to either specified IG, or the ability to provide synthetic data that can be used to construct bundles that conform to the specified IGs.

The Track Leads will be providing a very limited number of simulated Health Data Exchange App (HDEA - backend services app) environments for use during the Connectathon - of course we are also encouraging participants who have the capacity to implement their own test environments to do so and particpate in the track. At a minimum those participants who are preparing their own simulated environments should have the ability to send bundles conforming to either specified IG. You will be provided with the Appropriate API Key for machine to machine connectivity.

Track Lead(s)

Nagesh (Dragon) Bashyam, Aaron Seib. Backup: Mark Scrimshire

Track Lead Email(s), (backup:

Specification Information

HealthCare Survey Content IG 0.1.0 STU1 Ballot

Electronic Case Reporting (eCR) FHIR IG

Making Electronic Data More available for Research and Public Health (MedMorph) 1.0.0 STU1 / Continuous Integration Build

2022-01 MedMorph Track ( Sub-tracks: Health Care Surveys Reporting, Central Cancer Registry Reporting, Research Data Exchange)

Zulip stream

Track Kick off Call

Thursday April 27th at 1pm-2pm ET
Zoom Link:

Recording of Track Kick-off Call:
Passcode: &jNM8x9.

Track Kick-off Deck: CAT33 Track Kick Off Call MedMorph.pptx 

Pre-Connectathon Office Hours session:

Wednesday, May 3rd. 12:00 - 1:00pm ET

Optional meeting for Testing participants. We will keep the call open for 15 minutes. Please dial in early if you have questions (or let us know in advance when you are able to join the call).

Aaron Seib has reached out to volunteer testers individually already. This is an opportunity to address any last-minute questions as we complete preparations for the weekend’s testing event.

Zoom Link:

Meeting ID: 874 1829 8907

 Testing Scenario:

System Roles

Data Submitter: providers, EHR systems and HIEs that can post FHIR bundles.

Data Receiver: a CDC system that can receive and validate FHIR bundles.

NOTE: CDC Representatives will be operating a common Data Receiver platform at the connectathon and hope to have all participants submitting to it.

Health Care Surveys Reporting

The following are example scenarios enabled by the implementation guide:

  • Health Care Survey administration and reporting from an ambulatory setting to NCHS.

  • Health Care survey administration and reporting from an inpatient or emergency department or hospital-based outpatient setting to NCHS.


  • FluSurv-NET reporting from a hospital setting to a FluSurv-NET site (the CDC endpoint will play the role of a FluSurv-NET site).

Knowledge Artifact Repository (KAR), Health Data Exchange App (HDEA - backend services app) using eCR Now project, EHR, Public Health Agency (PHA)/CDC

Base Scenario: Data Submission Workflow (HDEA, PHA/CDC)

An HDEA (or proxy) submits data to PHA/CDC directly using the $process-message operation. 

  • Success Criteria:  Status of Success (HTTP codes 2xx) for well formatted data, successful validation of the submitted FHIR Bundles containing the FluSurv-NET data(eCR resources) and HCS data.

  • OperationOutcome indicating - Status of failure (HTTP codes 4xx) for badly formatted data or for data with validation errors.

Bonus Scenario 1: Export data from CDC FHIR Server to a Data Lake

The target CDC Data Lake will not be available in time for the Connectathon. However, a temporary Data Lake will be established that enables the export of data from the CDC FHIR Server to be demonstrated.

  • This will demonstrate the export of HCS and Flu-Surv data to a Data Lake.

Bonus Scenario 2: Demonstrate a visualization of data from a Data Lake using data collected via the CDC FHIR Server

The temporary Data Lake will be used to support a visualization of extracted FHIR data using PowerBI. This should demonstrate the potential capability to gain insights from data received via the CDC FHIR Server.

  • The visualizations will be generic data analyses, sufficient to demonstrate the capability to evaluate FHIR data exported to a data lake. 

HDEA Workflow Testing Scenario

Note: all these workflows have been tested at previous HL7 Connectathons

Creation and Publishing of Knowledge Artifact (FluSurv-NET and HCS Programs)

  • Action: The PHA publishes a Knowledge Artifact to be used by clinical care. The Knowledge Artifact includes the PlanDefinition resource, ValueSets associated with the Trigger Codes and other resources such as Library.
  • Success Criteria:  Ability of the HDEA to process a Knowledge Artifact and process notifications.

Notification Workflow (EHR, HDEA)

Pre-Conditions: Providers entering data into the EHR

HDEA gets notified of changes to patient record and queries the EHR for patient data

  • Success Criteria:  Status of Success (HTTP codes 2xx) when data is successfully retrieved from the EHRs.
  • OperationOutcome indicating - Status of failure (HTTP codes 4xx) when data is not found.

NOTE: EHRs who want to natively implement the Knowledge Artifact processing can do so and skip this scenario.

NOTE: HDEA can be used along with the EHR to successfully process a Knowledge Artifact and be ready for notifications. If an EHR cannot notify via POSTMAN or some other client tool it can notify the HDEA as a proxy for the connectathon.

Data Collection Workflow (EHR, HDEA)

HDEA queries the data necessary to create the package for submission from the EHR.

  • Success Criteria:  Status of Success (HTTP codes 2xx) for well formatted data, creation of a Reporting Message Bundle containing the FluSurv-NET data(eCR resources) and HCS data.
  • OperationOutcome indicating - Status of failure (HTTP codes 4xx) for badly formatted data or unable to create the bundle or unable to validate the data.

HDEA or Proxy creates subscriptions in the EHR

NOTE: Dependent upon support for FHIR R4B subscriptions.

HDEA or Proxy processes Knowledge Artifacts and creates subscriptions in the EHR.

  • Success Criteria:  Status of Success (HTTP codes 2xx) for creating the subscriptions within the EHR.
  • OperationOutcome indicating - Status of failure (HTTP codes 4xx) for requests which do not succeed.


SMART on FHIR Backend Services is required for EHR participants and other participants to interact with each other.

For testing communication with the CDC Target FHIR Server machine tokens will be provisioned manually to enable secure data exchange.

Testing the Tokens will be conducted BEFORE the event. Either at the Track Kick-off or as a subsequent Security testing event.