| Vital Records IG harmonization | Cindy, Saul, Sarah | - VR_UpdatesHL7_Sept2023_v5_final.pptx
- Mortality and Birth
- NVSS Mod efforts
- Modernization- from batch legacy interjurisdictional exchange to record oriented FHIR based exchange
- NAPHSIS is engaged
- Current phase is mortality data to NVSS, YE23
- Next phase will be birth data to NVSS, testing in first quarter of 2024
- Medicolegal death investigation
- MDI Connect, lead by CDC foundation with working with CDC’s Collaborating Office of Medical Examiners and Coroners
- Other engagements’
- Mortality
- Landscape analysis- jurisdictional engagement
- As is of EHR to EDRS workflow
- Standards based integration of funeral homes within the mortality workflow
- Birth- data quality projects have been informing the use of SMAR on FHIR for birth reporting to VROs.
- Birth and Fetal Death Reporting
- VR Common Profiles Library
- Both IGs published in Oct 2021
- Will be seeking extensions today
- Working over summer on unballoted updates
- Want to align with VR death reporting
- Received approval 9/7/23 and publication from FMG 9/9 and want to publish both by end of Sept.
- Major updates for BFDR
- US Core 5.0.1
- Split resources with value sets (see slides)
- Added guidance on mother-child linkage and plurality and multiple births, sources of data
- IJE mapping updates to reflect changes in IG and format updates to align with VRDR, as well as change log for all updates.
- Library
- Updated to US Core 5.0.1
- Split resources
- Added death related profiles
- Patient plurality
- Change log
- MDI Development
- STU 1 published 9/2022
- STU 1.1 unballoted updates, started in 2022
- Updates in progress now and expected to be completed by end of this month with publication expected late 2023
- Bundles and compositions for bidirectional exchange
- DocumentReference
- Narrative pages
- Change log.
- VRDR IG
- Just short of TSC approval to publish unballoted updates (STU 2.2)
- Want jurisdictions to be able to submit FHIR for death records by end of the year.
- Update reflects findings from jurisdictions as folks began implementing.
- Addresses all known data requirements
- Planned future work involves refactoring of vital records IGs to reduce redundancy
- NEXT Steps on all 4 IGs
- NVSS has 3 feeds from jurisdictional VR offices
- Want to transition all of these to record-based submission via FHIR
- Medicolegal Death Investigation- COMEN team working with CDCF on various information exchanged among the MDI office participating in the collaborative
- Goals of Harmonization
- Support known/anticipated use cases
- Continued development of BFDR to support EBRS-NCHS and EBRS-EBRS use cases
- Eliminate redundancy and improve consistency of representation among VR IGs
- Consistent documentation style across vital records IGs to ease Implementation.
- Want all 3 IGs to leverage the VR common library and use US Core 5.0.1
- Wanting to Harmonize BFDR with Birth Defects IG (with VRCPL and USCore 5.0.1)
- Comment about moving some more broadly used profiles into the PH Common Profiles Library since they are not specific to VR, like education.
- Also should be able to document more than one occupation in accordance with the ODH profile, right now only permits one on the return
- Consolidate Birth content into BFDR
- Consolidate Death content into the VRDR
- Common demographic elements, extensions, value sets into VR Common Profiles Library
- Go to Ballot in January 2024, approve NIB by Nov for VRCL & BFDR
- May or Sept Ballot 2024 for VRDR and MDI
- BFDR/VRCPL STU Extension Requests:
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| BSeR ballot recon | Sarah | - https://jira.hl7.org/secure/Dashboard.jspa?selectPageId=16617
- Didn’t pass
- 201 comments, 153 change requests
- Technical Corrections-Vote Group 1
- Reviewed all Confirmed Typos x 12
- 41213, 41653, 41827, 41829, 41985, 41993, 42199, 42208, 42226, 42227, 42663
- Motion- Sarah moves to approve all 12 in group 1 as persuasive
- Second- John Loonsk
- Abstain-0
- Against-0
- For- 16
- Slightly more than Typos- Vote 2
- Change requests and technical
- 2 in person comments, both have been reviewed and approved by commenter
- Reviewed all in group 2. 41209 pulled
- 41205, 41207, 41210, 42110, 42454, 42458, 42463, 42464, 42494, 42511
- Motion- Sarah moves to approve group 2 as documented
- Second- John Loonsk
- Abstain-0
- Against-0
- For- 15
- Change Requests- Vote 3
- Only 2 included, both reviewed
- 41810, 41861
- Motion- Sarah moves to approve group 3 as documented
- Second- John Loonsk
- Abstain-0
- Against-0
- For- 15
- Change Requests- Vote 4
- Only 3 included, all three reviewed.
- 41208, 42350, 42518
- Motion- Sarah moves to approve group 4 as documented
- Second- John Loonsk
- Abstain-0
- Against-0
- For- 15
- 42108-
- 1 Trigger Events and State Transitions (table) needs to be updated
- Similar comments made by others. Will group as a block and review.
- 42111-
- May be able to derestrict a bit, may want to provide guidance as to why its restricted if it needs to be restricted.
- Its difficult know when to apply the must support flag because its hard to find that definition
- Need to research
- 42113-
- Harmonization with Gravity
- May want to include some narrative to explain
- Can have chained referrals and referrals can be broken up
- Marked as persuasive
- Will add guidance on when and how to use basedOn- i.e. changing of referrals
- Motion- Sarah moves to approve 42113 as persuasive
- Second- John Loonsk
- Abstain-0
- Against-0
- For- 15
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