The Coordinated Federal Health IT Plan for 2008-2012 calls for developing a Nationwide Health Information Network (NHIN) of regional electronic health information exchanges built upon Electronic Health Record (EHR)-based systems (EHR-S) deployed in clinical practice. Various clinical and public health information systems have to be integrated in a NHIN.
To date, most clinical and public health information systems operate as stand-alone systems precluding bi-directional electronic health information exchanges. Building interoperable health information systems under a NHIN requires users and vendors to work together in a new way to assure that their individual applications are interoperable with multiple EHR-Ss and public health information systems involved.
The Public Health Data Standards Consortium (Consortium) has created an iterative process allowing public health agencies and the clinical community to communicate their respective needs for information technology applications to vendors via the means of Functional Standards, i.e., a structured description (specification) of user’s workflow and data flow that the information system will support. This process assures the use of health information technology standards and promotes the development of interoperable information systems.
The Consortium approach is to use the Functional Requirements Analysis Document (FRAD)to specify user needs to vendors. First tested in describing user functional requirements for EHR-S-based information exchanges with the school health information system and syndromic surveillance information system in New York City, the FRAD was successfully used to describe user functional requirements for EHR-S-based information exchanges in diabetes care management and surveillance in Wisconsin as described in the Report below.
The Report further described how the Wisconsin FRAD was used for informing the development of the Care Management Technical Framework at the Integrating the Healthcare Enterprise (IHE)– an umbrella specification for vendors to build standard-based information exchanges based on care management guidelines. In addition, the Report provides an overview of clinical and public health functions and data requirements for clinical and public health registries built upon EHR-based systems.
This project was funded by the Contract from the Health Resources and Services Administration (HRSA) # 07-S250-0827-AB.
Standards for Public Health Data Exchange: Functional Requirements Standard for Diabetes Care Management and Surveillance