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45 mineCR UpdateJohn LoonskNEED SLIDES

View file
nameeCR Update PHWG 9-13.pdf

  • Metrics:
    • >28,000 HCOs in production
    • 2073 hospitals
    • 355 critical access hospitals
    • 1472 FQHCs
    • 11441 ambulatory facilities
  • Accelerated onboarding for EHRs
  • 66 EHRs engaged in onboarding
  • Wanting to drive everyone to FULL eCR where 200 + conditions are supported by eCR as opposed to COVID Only
  • Currently only functional requirements in rules, no standard specified
  • Wanting to see specific eCR standards include in certification (CDA or FHIR) and the specific release CDA eICR R3.1 and FHIR eICR R2.1
  • Need to move in this direction to address needs in data quality
  • Data Quality
    • Desire for processable data
    • Process for improvement include:
      • Quality assurance working group
    • DQ schematron; PHAs can get technical support to implement schematron during the HCO onboarding process.
      • DQ monitoring report. DQ schematron and monitoring report goes through each data element to determine completeness quality. Given to HCO and EHR vendor during onboarding so they have a clear view of how data coming from them don’t meet the requirements for public health. It is also used during the onboarding process by AIMS to help advance quality improvements
    • “Requiredness”
      • Requiredness is also expressed with the quality of the data, including where data and /or terminologies are required to be
      • Despite having some degree of requiredness, but none meet complete needs
      • None of the current federal levers results in getting high quality machine processable complete data for PH
    • Part of this is a communication issue and attempting to generate and provide feedback with regards to quality through the DQ monitoring report
    • FHIR is as irregularly implemented as CDA right now or more so
    • Issues in clinical workflow, feeding systems, EHR interfaces, mapping into resources, API...
    • Because the needs of data is different for Public health vs HCO, data quality needs to be more of a priority of standard work, regulation, and national conversation.
45 min

BSeR update and ballot recon

Sarah G.


  • US public health profiles library (USPHPL) are a collection of sharable reusable FHIR profiles
  • It is intended to complement US Core. The profiles are intended to be referenced and used by US public health implementation guides to foster interoperability not addressed in US Core.
  • 0 published in 8/2023
  • IG publisher version that includes the USPHPL check is expected later this month
  • IG Publisher QA report will have a warning if a developing IG develops a profile that already exits in USPHPL
  • IG developer will need to use the USPHPL profile or engage PHWG to request a variance
  • The USPHPL exist in both eICRs, Medmorph IGs
  • Moving forward will develop closers relationships with USCDI+, VR CPL, and additional PH programs
  • Some USPHPL are needed refinements of US core profiles. There are ongoing processes to retire some profiles when a functional US Core version is available .
  • Implementing committee processes with the PH WG
  • Would like to develop support for ongoing maintenance
  • Draft USPHPL Exception Process Document on our confluence page – US PHPL Variance Request Process
  • Suggestions: Include narrative that explains the relationship between this and other artifacts like PHIN VADS/VSAC. Include a flow diagram for implementers

BSeR Ballot recon 

  • Group 5 - 42206, 42207, 42217
    • Motion- Sarah moves to approve as persuasive
    • Second-John Loonsk
    • Abstain-0
    • Against-0
    • For- 20
  • 42218
    • Remove MustSupport on slices for Task.Identifier
    • Need to research
  • 42221
    • Remove MustSupport on Task.note
    • Would like some guidance on when to use note as opposed to other
    • Need to research
  • 42220
    • Relax Cardinality on subject of task
    • Could provide general guidance on expecting subject present in needed resources. Could provide guidance that the task preceding the service
    • Need to research
  • 42225
    • Motion- Sarah moves to find 42225 persuasive
    • Second- John Loonsk
    • Abstian-0
    • Against-0
    • For-19