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1a. Project Name

Making EHR Data More Available for Research and Public Health (MedMorph) Reference Architecture HL7 FHIR Implementation Guide

1b. Project ID


1c. Is Your Project an Investigative Project (aka PSS-Lite)?


1d. Is your Project Artifact being Reaffirmed or proceeding to Normative directly after being either Informative or STU?


1e. Today's Date

Feb 20, 2020

1f. Name of standard being reaffirmed

1g. Project Artifact Information

1h. ISO/IEC Standard to Adopt

1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption?


1j. Unit of Measure

2a. Primary/Sponsor WG

Public Health

2b. Co-Sponsor WG

FHIR Infrastructure

2c. Co-Sponsor Level of Involvement

Other Involvement. Specify details in text box below

2c. Co-Sponsor Involvement

Notification of ballot-ready content for review

2c. Co-Sponsor Update Periods


2b. Co-Sponsor WG 2

Biomedical Research & Regulation

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Involvement


2c. Co-Sponsor 2 Update Periods

Monthly and at WGMs.

2c. Co-Sponsor Involvement


2c. Co-Sponsor 3 Update Periods


2d. Project Facilitator

Nagesh Bashyam, Brett Marquard

2e. Other Interested Parties (and roles)

Aaron Harris, Abigail Viall, Arunkumar Srinivasan, Brian Gugerty, John Loonsk, Laura Conn, Maria Michaels, Sameemuddin Syed, Teresa Kinley, Wendy Blumenthal
Patient Care Workgroup
EHR Workgroup

2f. Modeling Facilitator

Brett Marquard

2g. Publishing Facilitator

Nagesh Bashyam

2h. Vocabulary Facilitator

Brett Marquard

2i. Domain Expert Representative

Maria Michaels,

2j. Business Requirements Analyst

Brian Gugerty (HCS), Wendy Blumenthal (Cancer), Aaron Harris, Abigail Viall(Hep C)

2k. Conformance Facilitator

Nagesh Bashyam

2l. Other Facilitators

2m. Implementers

Dynamic Content Group

3a. Project Scope

The goal of the MedMorph project is to develop and pilot a scalable and extensible standards-based reference architecture. This reference architecture will enable clinical data exchange with EHR systems and public health systems, specialized registries, national health care survey systems, and research information systems for multiple conditions. Initially, the reference architecture will be outlined using three priority use cases:
Hepatitis C
Health Care Surveys
The MedMorph project will leverage, where appropriate, existing FHIR resources and profiles, CCDS and USCDI definitions, and CQL to improve patient data exchange from different EHR platforms to various receiving systems. The use of standards will help improve the timeliness and completeness of data collected by public health and research and reduce the burden on health care providers and patients.
There are some overlaps in current HL7 projects such as the CDA STU Public Health electronic Initial Case Report (eICR) and FHIR Electronic Case Reporting (eCR) in HL7 PSS #136. These projects focus primarily on an 1) initial case report for reportable conditions, 2) a bidirectional communications transaction, the Reportability Response, and 3) a specification (the electronic Reporting and Surveillance Distribution (eRSD)) to help automate reporting. MedMorph will look to leverage this work and the work of the FHIR Common Reporting Framework and expand the focus to include research and chronic reporting.
This FHIR implementation guide will use the US Core profiles as needed and appropriate. If this FHIR implementation guide is unable to use a US Core profile, we will work with the primary sponsoring workgroup to create new profiles or extend existing ones.
The project is incremental, will evolve, and the sponsoring work group will receive regular updates.


3b. Project Need

While FHIR IGs exist for some research and public health use cases, many have focused on a specific use case without an underlying common architecture that can help minimize efforts for both the senders and receivers of data. The combination of industry-accepted standards such as FHIR and a common architecture can bring together disparate approaches to meet the needs for specific use cases while minimizing the burden on senders and receivers of data. MedMorph seeks to develop a reference architecture that will provide a common reporting framework for public health and research use cases. Applying a common framework can address many public health initiatives, such as:
Electronic case reporting
Syndromic surveillance
Chronic disease surveillance
Public health and clinical registry reporting
Healthcare surveys
Additionally, developing a common Reference Architecture will limit proliferation of IGs for public health and promote configuration over proprietary implementation.
The project will leverage the existing US Core FHIR profiles and will only create new profiles if existing profiles cannot meet the project requirements.

3c. Security Risk

3d. External Drivers

3e. Objectives/Deliverables and Target Dates

FHIR IG: Sept 2020 Ballot

3f. Common Names / Keywords / Aliases:


3g. Lineage

3h. Project Dependencies

3i. HL7-Managed Project Document Repository URL:


3j. Backwards Compatibility


3k. Additional Backwards Compatibility Information (if applicable)

3l. Using Current V3 Data Types?

3l. Reason for not using current V3 data types?

3m. External Vocabularies


3n. List of Vocabularies

3o. Earliest prior release and/or version to which the compatibility applies

4a. Products

FHIR Implementation Guide

4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to?


4c. FHIR Profiles Version


4d. Please define your New Product Definition

4d. Please define your New Product Family

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. White Paper Type

5a. Is the project adopting/endorsing an externally developed IG?


5a. Externally developed IG is to be (select one)

5a. Specify external organization

5a. Revising Current Standard Info

5b. Project Ballot Type

STU to Normative

5c. Additional Ballot Info

5d. Joint Copyright


5e. I understand I must submit a Joint Copyright Letter of Agreement to the TSC in order for the PSS to receive TSC approval.


6a. External Project Collaboration

Digital Bridge

6b. Content Already Developed


6c. Content externally developed?


6d. List Developers of Externally Developed Content

6e. Is this a hosted (externally funded) project?

6f. Stakeholders

Clinical and Public Health Laboratories, Immunization Registries, Quality Reporting Agencies, Regulatory Agency, Other

6f. Other Stakeholders

Research Community

6g. Vendors

Pharmaceutical, EHR, PHR, Health Care IT, Clinical Decision Support Systems, Lab

6g. Other Vendors

6h. Providers

Clinical and Public Health Laboratories, Local and State Departments of Health, Healthcare Institutions (hospitals, long term care, home care, mental health)

6h. Other Providers

6i. Realm

U.S. Realm Specific

7d. US Realm Approval Date

Mar 03, 2020

7a. Management Group(s) to Review PSS


7b. Sponsoring WG Approval Date

Feb 20, 2020

7c. Co-Sponsor Approval Date

Mar 23, 2020

7c. Co-Sponsor 2 Approval Date

Mar 24, 2020

7c. Co-Sponsor 3 Approval Date

7c. Co-Sponsor 4 Approval Date

7c. Co-Sponsor 5 Approval Date

7c. Co-Sponsor 6 Approval Date

7c. Co-Sponsor 7 Approval Date

7c. Co-Sponsor 8 Approval Date

7c. Co-Sponsor 9 Approval Date

7c. Co-Sponsor 10 Approval Date

7e. CDA MG Approval Date

7f. FMG Approval Date

Mar 03, 2020

7g. V2 MG Approval Date

7h. Architecture Review Board Approval Date

7i. Steering Division Approval Date

Apr 06, 2020

7j. TSC Approval Date

Apr 13, 2020