204464 Development of an Implementation Guide to Enable Public Health Case Reporting of Electronic Medical Record (EMR) data in HL7 Clinical Document Architecture (CDA) format

Tuesday, November 10, 2009

John P. Abellera, MPH , Office of Surveillance, Epidemiology, and Laboratory Services (OSELS), Centers for Disease Control and Prevention (CDC), Atlanta, GA

Reportable conditions are diseases considered to be of great public health importance. Local, state, and national agencies require that such diseases be reported when they are diagnosed by clinicians or laboratories. First in the process is occurrence of the condition itself. The case reporting workflow is triggered by identification of a reportable condition by a health care worker. The event is then reported to the local or state public health system to prompt an investigation.

This presentation provides an overview in the development of a standard message format to send a CDA (Reporting) document, created by the healthcare facility or provider, to state and local public health agencies.


The CDA Public Health Case Reporting project followed the Presidential Initiative White House E-gov Consolidated Health Informatics (CHI) standards adopted by CDC's Public Health Information Network (PHIN). The guidelines were used in the review of data elements (N=259) to identify the appropriate codes. Pre-defined heuristics (Question and Answers vs Assertion style) were taken into account.


The assignment of codes, along with the application of heuristics, for each data element resulted in 1) a reduction in the number of data elements from the original list; 2) reassessment in the utility of data elements to support case reporting (vs. case investigation); and 3) recommendations for inclusion of additional data elements to support the intended use case of the IG.


The CDA for Public Health Case Reporting project will constrain CDA to meet the requirements of disease-specific case reports (e.g., Anthrax, Hepatitis B, Tuberculosis and Tularemia). The foundation of this effort will be a set of modular definitions (templates) reusable across forms for other conditions and conformant with design patterns established for EMRs and interoperable data exchange.

Learning Objectives:
1. Describe the business need to develop a implementation guide for public health case reporting 2. Describe the process leading up to the development of the implementation 3. Explain the challenges in developing standards for electronic exchange of case report data 4. Sare lessons learned

Keywords: Reporting, Standards

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Employment - Centers for Disease Control and Prevention, National Center for Public Health Informatics,Division of Integrated Surveillance Systems and Services,Position: Health Scientist
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.