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Dan Rutz pointed out a typo in
FHIR-38429
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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"
FHIR-39305
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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
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
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)
