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Birth and Fetal Death Reporting (BFDR)

The purpose of this project is to create an HL7 Fast Healthcare Interoperability Resources implementation Guide (FHIR BFDR IG) standard to support the needs of NCHS and its jurisdictions to successfully implement the electronic reporting of birth and fetal death information. The scope of this HL7 FHIR BFDR IG will include the content of medical/health information on live births and fetal deaths for select state and Federal birth and fetal death reporting, as indicated in the 2003 Revision of the U.S. Standard Certificate of Live Birth and the U.S. Standard Report of Fetal Death. Additionally, it will include the content that is exchanged between EHRs, jurisdictions, and NCHS. In the case of fetal death, return coded cause of death, and race and ethnicity information back to the state.

To continue support of interoperability among public health systems, there is a need to develop a FHIR IG for birth and fetal death reporting. Development of the FHIR IG for birth and fetal death will provide national data standards that will support the implementation of FHIR for NCHS, Jurisdictional partners and EHR vendors.

Project Roadmap page: Vital Records Birth and Fetal Death Reporting FHIR IG

Scenario Objectives

Test the draft version of the Birth and Fetal Death FHIR Implementation Guide.

Specific testing:

Related Scenarios

We will have significant content overlap with the Birth Defects FHIR IG: Birth Defects Reporting (BDR)

Birth and Fetal Death Reporting FHIR IG uses profiles defined in the Vital Records Common Profile Library.

Proposed Scenario Leads

Sarah Gaunt, sarah.gaunt@lantanagroup.com

Cindy Bush, pdz1@cdc.gov

Expected participants

Georgia Department of Public Health

  • Genesis Systems

Michigan Department of Health and Human Services

  • Altarum 

Utah Department of Health

Scenario Orientation

TBD: A webinar will be hosted on date at time to share further participation information about this scenario.

System Roles

Submitter: This actor will gather the clinical content related to the birth or fetal death report to prepare and transmit a FHIR bundle according to the IG specifications.

Receiver: This actor will receive the FHIR bundle, validate it and process it.

BFDR Tools and References

  • https://build.fhir.org/ig/HL7/fhir-bfdr
  • TODO - add link to Jira page for issues
  • Live Birth
    • Google Sheet containing facility worksheet items noting priority (SHALL, SHOULD, MAY), data sources, and mappings to FHIR profiles
    • Completed facility worksheet for live birth using example data (TODO - add link to filled out Facility Worksheets)
    • Profile instances using example data (TODO)
    • TODO: create page with BFDR-specific instructions on how to use the FHIR Validator to validate and link to page
  • Fetal Death
    • Google Sheet (todo) containing facility worksheet items noting priority (SHALL, SHOULD, MAY), data sources, and mappings to FHIR profiles
    • Completed facility worksheet for fetal death using example data (TODO - add link to filled out Facility Worksheets)
    • Profile instances using example data (TODO)
    • TODO: create page with BFDR-specific instructions on how to use the FHIR Validator to validate and link to page

Scenarios for workflow EHR to Jurisdictional Vital Records Office Electronic Birth Registration System (EBRS)

  • Provider EHR to Vital Records: EBRS (worksheet)
    • EHR could create and validate
    • EHR could create and send to EBRS

TODO- Get process flow picture from other IG (V2/CDA?)

Scenario 1: EHR will create and validate a Document Bundle containing Composition - Provider Supplied Facility Live Birth Report

Action:

  • Create a Document Bundle containing the Composition - Provider Facility Live Birth Report consisting of required data (SHALL data elements) on the newborn patient, related participants and birth certificate data
  • Validate the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and add a link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is valid against the BFDR IG

Bonus:

Scenario 2: EHR will send Document Bundle containing Composition - Provider Supplied Facility Live Birth Report

Action:

  • Create a Document Bundle containing the Composition - Provider Facility Live Birth Report consisting of required data (SHALL data elements) required data on the newborn patient, related participants and birth certificate data
  • Send the Document Bundle to the EBRS recipient
  • EBRS Receiver validates the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is consumed by the recipient
  • FHIR Bundle is validated against the BFDR IG

Bonus:

Scenario 3: EHR will create and validate a Document Bundle containing Composition - Provider Supplied Fetal Death Report

Action:

  • Create a Document Bundle containing the Composition - Provider Supplied Fetal Death Report consisting of required data on the deceased fetus, related participants and fetal death report data
  • Validate the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is valid against the BFDR IG

Bonus:

Scenario 4: EHR will send Document Bundle containing Composition - Provider Supplied Fetal Death Report

Action:

  • Create a Document Bundle containing the Composition - Provider Supplied Fetal Death Report consisting of required data on the deceased fetus, related participants and death report data
  • Send the Document Bundle to the EBRS recipient
  • Receiver validates the Document Bundle against the BFDR IG using the FHIR Validator
  • (TODO: create page with instructions on how to use the FHIR Validator to validate and link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is consumed by the recipient
  • FHIR Bundle is validated against the BFDR IG

Bonus:


Scenarios for Jurisdictional Vital Records Office:  EBRS to EBRS

  • Jurisdiction to jurisdiction (full set of data -mother's + facility + local)
    • EBRS could create and validate
    • EBRS create and send also to another EBRS
    • EBRS receive and consume (and validate)
    • (EMR won't collect mother's worksheet)

Scenario 1: An EBRS will Create and validate a Document Bundle containing Composition - Jurisdiction live birth report

Action:

  • Create a Document Bundle containing the Composition - Jurisdiction live birth report consisting of required data on the newborn patient, related participants and birth certificate data
  • Validate the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and add a link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is valid against the BFDR IG

Scenario 2: An EBRS will send Document Bundle containing Composition - Jurisdiction live birth report 

Action:

  • Create a Document Bundle containing the Composition - Jurisdiction live birth report consisting of required data on the newborn patient, related participants and birth certificate data
  • Send the Document Bundle to another participating EBRS recipient
  • EBRS Receiver validates the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is consumed by the recipient
  • FHIR Bundle is validated against the BFDR IG

Scenario 3: An EBRS will Create and validate a Document Bundle containing Composition - Jurisdiction Fetal Death Report

Action:

  • Create a Document Bundle containing the Composition - Jurisdiction Fetal Death Report consisting of required data on the newborn patient, related participants and birth certificate data
  • Validate the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and add a link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is valid against the BFDR IG

Scenario 4: An EBRS will send Document Bundle containing Composition - Jurisdiction Fetal Death Report

Action:

  • Create a Document Bundle containing the Composition - Jurisdiction Fetal Death Report consisting of required data on the newborn patient, related participants and birth certificate data
  • Send the Document Bundle to another participating EBRS recipient
  • EBRS Receiver validates the Document Bundle against the BFDR IG using the FHIR Validator (TODO: create page with instructions on how to use the FHIR Validator to validate and link to page)

Success Criteria:

  • FHIR Bundle is produced

  • FHIR Bundle is consumed by the recipient
  • FHIR Bundle is validated against the BFDR IG
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