Standards and Vital Statistics:

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Standards and Vital Statistics

• Building an HL-7 Vital Events Message
• Delton Atkinson, MSPH, MPH, PMP
• NCHS Consultant
• Lockheed Martin Information Technology
• June 8, 2004

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Session Agenda

• Importance of Messaging
• National Health Information Infrastructure
• History of Vital Events Messaging
• Accomplishments to Date
• Where Do We Go Next

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Budget Bureau Prediction

• .it can not be assumed that the need for
  adequate vital records will disappear after the
  war emergency is ended on the contrary, the
  course of social evolution points to continually
  increasing needs for official records of the
  existence, identity and status of individuals,
  and for statistics based on such records.

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In the World of Technology..

• Just Imagine.?

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Just Imagine..?

• Government to Customer Transactions

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Just Imagine..?

• Government to Customer Transactions
• Government to Business Transactions

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Just Imagine..?

• Government to Customer Transactions
• Government to Business Transactions
• Government to Government Transactions

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National Health Information Infrastructure (NHII)

• Report in December 2001
• Heart of the Vision sharing information and
  knowledge appropriately so it is available to
  people when they need to make the best possible
  health decisions

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Basic Elements of the NHII

• Values
• Practices and relationships
• Laws and regulations
• Privacy
• Standards
• Technology
• Systems and Applications

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Element 2 Practices Relationships

• Facilitate the flow of health information and
  knowledge and communication both within sectors
  and between them
• Changes in information sharing practices

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Element 5 Standards

• Building blocks of effective information systems
• Essential for effective and efficient public
  health and health care delivery systems
• HIPPA put into motion activities that move health
  information toward standardization.

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Advancing Health IT National Goals

• Assuring that most Americans have electronic
  records within 10 years
• HL-7 level functional model and standards for
  electronic records
• Interoperable health information infrastructure
• Creation of Office of Health Information
  Technology in 2004, with Dr. David J. Brailer as
  first director.

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Where is Vital Statistics in this Context?

• Brainstorming about vitals, standards, and
  communication in 2001
• Defining Events
• Appeal to be a part of NEDSS
• Conceptualization of EVVE

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Summer 2001

• New Mexico Annual Meeting
• Standards-based approach to vital statistics
• Re-engineering launched
• Joint Meeting with CDC Informatics Officials
• Vital Statistics Messaging is born.

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Fall of 2001

• First Working Group formed to craft a vital
  events message
• NAPHSIS
• CDC
• CDC-sponsored contractor
• NEDSS Cooperative Agreement w/ NAPHSIS
• Travel to NEDSS Conference
• Participate in standards setting coalitions
• Educate membership about NEDSS standards

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Summer of 2002

• Formation of the Re-engineering Oversight
  Committee, which established 6 subcommittee
  EDRS, EBRS, POS, Data Analysis,
  Reports/Files/Outputs, and IT.
• Vital Events Messaging Initiative assigned to IT
  Committee
• IT Sub-committee creates HL-7 Working Group

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Spring 2003

• HL-7 Working Group presents to PHDC
• PHDC agrees to help
• New Messaging Work Group formed
• HL-7 Working Group
• PDC
• NCHS/DVS
• CDC-Atlanta
• Consultants
• PDC secures funding for part-time staff

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Accomplishments

• Constructed electronic message specifications for
  births and deaths
• Agreement reached on differences in vocabularies
  (e.g., race and ethnicity) and maintenance of
  vocabularies.
• HL-7 to maintain highest level of RE codes
• CDC to maintain granular levels

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Accomplishments, etc.

• Selected births as the first vital event to seek
  standard for.
• Selected HL-7 Version 3 as the tool for the
  development of the standard message.
• Briefing of HL-7 Accrediting body completed.
  Assigned to Public Health Emergency Response
  Special Interest Group

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Next Steps

• Develop a white paper on the business case on
  messaging for the vital statistics community
• Develop a pilot project on messaging
• Develop the first HL-7 implementation guide
• Marshal the first package through the HL-7
  approval process
• Implement the PHIN messaging system at NCHS.

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Why Vital Statistics Messaging?

• National standards for health information
  exchange are coming
• Health information systemsboth private and
  public will have to follow these national
  standards.
• More importantly,

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With Standards

• It is better to lead than follow !