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Attendees


Name

Affiliation

Aaron Ling CDPH
Becky Angeles Carradora Health
Clifford S. Mitchell, MS, MD, MPH Director, Environmental Health Bureau, Maryland Department of Health
Craig Newman Altarum
Cynthia (Cindy) Bush CDC/NCHS
Dan Rutz Epic
Danny Wise Allscripts
Erin Holt Coyne TN Dept of Health
Forrest White Altarum
Genny Luensman ATL, Inc. (Contractor for CDC/NIOSH)
Heather Patrick CDC contractor (Peraton)
Jamie Parker Carradora
Kathy Walsh Labcorp
Kristi Eckerson HLN Consulting, LLC
Maria Michaels CDC
Mike Flanigan Carradora Health
Sandy Jones CDC - Cancer Registry
Shirley Burton CDC/NIOSH/RHD
Sophia Cantor WA DOH/CSTE
Tony Winters PHII





Chair: Craig Newman 

Scribe: Danny Wise 


Discussion items

Time

Item

Who

Notes

5 min.Welcome, agenda review, meeting minute approval Craig

last week's minutes approved as posted; no concerns or corrections raised

10 min.US Public Health Profile Library Block VoteSarah
  • no requests to pull any comments were received
  • Dan Rutz pointed out a typo in  FHIR-38429 - Getting issue details... STATUS for both the "original" and "updated" language of one of the proposed changes ("The profile concept is captured in operational in at least one EHR or public health system")
    • will be corrected as "The profile concept is captured and operational in at least one EHR or public health system"
  • block approved 24-0-1 (motion: Sarah, second: Erin)
15 min.MedMorph Reference Architecture IG review, publication approvalDragon
  • FHIR-39305 - Getting issue details... STATUS was created last week to remove the dependency on the Subscriptions Backport IG (see explanation from 10/13/2022 minutes)
  • updates were also made to the pre-publication IG last week
  • notice was sent to the WG listserv about the ticket and updated IG last Thurs. 10/20/2022
  • revisited publication request re-approved for updated IG 25-0-2 (motion: Dragon, second: Maria)
  • per recommendation from Austin during 10/13/2022 call, project team will draft a notice to send to the ballot pool (since substantive changes were made after the original reconciliation package was uploaded to the Ballot Desktop and notice previously sent to negative voters), and send it to the co-chairs to e-mail out via the Ballot Desktop
30Environmental Health data sharingCliff Mitchell
  • HL7PubHlth_Informatics_102722.pdf
  • Cliff Mitchell. Director, Environmental Health Bureau, Maryland Department of Health
  • what is environmental health? – food protection, drinking water, waster water mgm't., hazardous waste, land mgm't., etc.
    • environmental health services include licensing, permitting, inspecting (e.g., wells)
    • relies on statutes / l;aws from FDA, EPA, state and local jurisdictions
  • fragmented agencies with minimal data interoperability
    • business data (licensing, inspections, etc.) – some of this is currently captured in a REDCap system
    • environmental health monitoring data
    • lab sampling and results – can use standardized concepts from HL7, LOINC
    • personal health data – can use existing HL7 standards
  • there is a need for messaging standards for business and environmental health data, e.g.:
    • disease outbreaks
    • chemical spills
    • inspections (e.g., lead, heath hazards related to asthma)
  • example use case – integrating environmental health home inspections with the state HIE (CRISP)
    • e.g., multiple ER visits for a patient with asthma could link with existing REDCap system to trigger a new home inspection for that patient
  • Dan Albright (Michigan DHHS): Michigan is exploring how to tie environmental data to blood lead results
    • e.g., how to describe in a standard way that a home environment has peeling / chipping / flaking paint?
  • Steve Eichner (Texas DHHS): suggests creating an SME group to define terminology / data models first
  • Sophia Cantor (Washington State DOH): suggests reviewing HAI framework since it has similar goals and existing mechanisms to trigger investigations
  • Craig: recommends starting small; what's a good starting point?
  • Cliff: food satety / FDA – food service inspections are pretty well standardized already
    • also, home inspections can be relevant to clinical care (e.g., lead exposure) but aren't generally available to clinicians
    • REDCap surveys have a lot of data that's not all relevant to clinical care
  • Steve: recommends reaching out to physician community to find ways to make interpreting environmental health data easier (many physician's aren't trained on environmental health)
  • Craig: Questionnaire and QuestionnaireResponse FHIR resources could potentitally convey environmental health data
    • do EHRs consume these resources?
  • Steve: what about EHR-based triggering (i.e., CDS), e.g., based on blood lead results?
  • Danny: could implement a SMART app that bridges the gap between existing FHIR implementations in EHRs and REDCap vs. solutioning a new standard
  • if anyone has any further questions or feedback, please reach out to Cliff (cliff.mitchell@maryland.gov, 410-371-0635)