NSSP Onboarding Workgroup Meeting
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1 NSSP Onboarding Workgroup Meeting Date: Wednesday, June 3, 2015, 3:00 PM 4:30 PM EDT Attendees: Laurel Boyd, Karen Felicetta, Farah Naz, Sheryl Taylor, Laura McCrary, Brooke Evans, Laura Streichert, Anne Burke, Jill Baber, Paulina Osinska, Cynthia Levy, Lori Fourquet, Rob Snelick, Sara Imholte, Peggy Cobey, Travis Mayo Agenda: 1. Welcome and introductions 2. Jurisdiction updates (2 minutes per jurisdiction) 3. NSSP updates a. NIST 2015 Syndromic MU Certification Testing b. Data use agreement discussion 4. Presentation: Farah Naz, Kansas Department of Health and Environment - Improving Data Quality During (re)onboarding for Meaningful Use Stage 2 5. Discussion a. Presentation questions 6. Next meeting and action items Anne Burke, UT, largest syndromic provider working with Cerner, recently onboarded a quarter of facilities, working on re- recruiting facilities Laurel Boyd, OR, smaller health systems are changing EMRs, anticipating re- onboarding and looking for best practices, hiring a new epidemiologist (check out the posting on ISDS website!) Farah Naz, KS, Kansas DHE connection between HIE and NSSP broken, 19 are reconnected and working through data validation, documenting processes Cynthia Levy, working with NSSP team on developing specification for MU certication for the upcoming year Laura McCrary, KS, oversee the HIE in KS, connection has been down for a few months, hired a full- time integration engineer, GG is interested in receiving regular updates about organizations that are testing and in production Jill Baber, ND, extra outpatient facilities looking to onboarded, systems changing EMRs Laura Streichert, ISDS, MU Business Processing Survey is available here: Dan Chaput is very responsive and would be able to help with onboarding issues, send issues to meaningfuluse@cdc.gov Lori Fourquet, supporting NIST in updated HL7 surveillance for testing Paulina Osinska, WA, working through data validation issues and looking into contact management software Peggy Cobey, AL, onboarding through a HIE, going well, interested in getting a way for the vendor to see their data Karen Felicetta, NV, biggest challenge is issues with duplicates now looking at message ids Travis Mayo, NSSP, continuing to work on documentation, work on systems for validation for jurisdictions Rob Snelick, project lead at NIST for syndromic, developing MU certification tools including syndromic Sara Imolte, AZ, continuing to onboard hospitals, discussed ongoing issues with Cerner content and nonsensical messages (a01s and a04s for all admits, event date), data transmission issues, AZ is on hold for all Cerner implementations until issues are involved
2 Syndromic Surveillance Requirements ONC Edition 2015 Certification Testing Rob Snelick, National Institute of Standards and Technology E- mail: Objectives Provide background regarding Phases of testing Important tool for catching issues NIST is first phase of multi- phase testing o Phase 1- capabilities testing - conformance testing) o Phase 2 capabilities (conformance testing) o Phase 3 site interface testing interoperability testing 2014 Edition ONC syndromic surveillance certification criteria and testing 2015 Edition ONC Notice of Proposed Rule Making syndromic surveillance certification criteria Obtain initial thoughts from ISDS about Edition 2014 NIST Syndromic Surveillance Test Tool Likes vs dislikes regarding features and functions Modifications needed to content of Urgent Care and ED Test Cases to support Edition 2015 ONC certification testing New Test Cases and content needed for Edition 2015 Test Tool Identify subject matter experts to work with NIST and set the direction for Edition 2015 Syndromic Surveillance certification testing Additional analysis of new requirements in PHIN Guide 2.0 Develop PHIN Messaging Guide Addendum and Clarification Document as needed for certification testing Create and review Test Cases Test Scenario Matrix based on key requirements from PHIN Guide 2.0 Modifications to 2014 Edition Test Cases Content for new Test Cases Answer Google Groups questions Test the NIST Test Tool Review the artifacts/documentation provided with the Test Tool Help develop the testing process/procedure document and the associated documentation Highlights of Changes Analysis for Support SS R2 Testing Add support for Laboratory test values/results message requirements for SS Context- Free and Context- based Validation (Schema is primarily the same as ELR R2 with certain data elements and vocabularies that are unique to SS R2) Update Context- based Validation Test Cases to support User Stories (ADT messages) in the PHIN Guide 2.0 (such as IP Test Cases) Update data types More details on the treating facility and patient demographics, chief complaint and reason for visit Vital signs as OBXs (age, height, weight at minimum) Information on the patient s prior and current hospital area location
3 Details on the Reason for Admission Add changes for required vocabularies HL7 and External tables changed to CDC tables Changes to CDC tables Summary Provided background regarding Phases of testing 2014 Edition ONC syndromic surveillance certification criteria and testing 2015 Edition ONC Notice of Proposed Rule Making syndromic surveillance certification criteria Obtained initial thoughts from ISDS about Edition 2014 NIST Syndromic Surveillance Test Tool Likes vs dislikes regarding features and functions Modifications needed to content of Urgent Care and ED Test Cases to support Edition 2015 ONC certification testing New Test Cases and content needed for Edition 2015 Test Tool Sign- up Identify committed subject matter experts to work with NIST and set the direction for Edition 2015 Syndromic Surveillance certification testing Review initial analysis of additions/changes needed for 2015 Test Tool Develop PHIN Messaging Guide Addendum and Clarification Document as needed for certification testing Create and review Test Cases Modifications to 2014 Edition Test Cases Content for new Test Cases Answer Google Groups questions Test the NIST Test Tool Review the artifacts/documentation provided with the Test Tool Help develop the testing process/procedure document and the associated documentation Weekly meetings (send e- mail to Discussion NIST test tool may not be used to test ambulatory as does not meet ONC criterion NPRM only named standards for emergency NIST does not validate optional requirement Hoping send draft tool in September, final in December Is there a schedule for calls and comments? Improving Data Quality While (Re)Onboarding for Meaningful Use Stage 2 Farah Naz, MPH Syndromic Surveillance Coordinator, Epidemiologist Bureau of Epidemiology and Public Health Informatics Division of Public Health Kansas Department of Health and Environment fnaz@kdheks.gov Background
4 NSSP/BioSense ONLY Jurisdiction Emergency Departments Only 129 in State Five- Year Average ~6 Million Annual Visits Started collecting Syndromic Surveillance (SyS) data in 2011/2012 Meaningful Use Standards Used Meaningful Use Stage 1 Optional participation; could claim exclusion 105 EDs connected for MU1 Onboarding responsibility almost entirely outside of KDHE Focus on technical aspects Quality was low Meaningful Use Stage 2 January 2014 New Hire (Me!) April 2014 First MU2 Attesters Need to redo establish onboarding procedures Constantly updating Onboarding Overview Very basic no specialized software All phone conversations must follow- up via All s follow naming convention: [Facility Name] [Onboarding Phase] Standard drafts to start each onboarding phase All tracking done with Excel documents Fill out very basic form: Applying for Medicaid/Medicare/Both? EP/EH Measures they intend to submit to HIO Affiliation (if any) Reporting Period Basic demographic/contact information EHR Vendor Onboarding Process: Data Usage Agreement (DUA) PDF of DUA (with instructions) Standard ASTHO DUA for SyS Link to KDHE Meaningful Use Website: Onboarding Process: Data Usage Agreement (DUA) Kickoff Meeting SyS Coordinator schedules meeting minutes Establish Primary Contacts for Each Phase Attendees: KS Syndromic Surveillance Coordinator Technical Team Representative (NSSP or HIO) Hospital representatives People responsible for DEVELOPINING, CHANGING, and MAINTAINING syndromic surveillance interface (ex: interface developer)
5 Representative familiar with ER Workflow Any potential syndromic surveillance and/or meaningful use contact at facility (ex: Hospital administrator, hospital syndromic surveillance coordinator, etc) Connectivity: Lead by Technical Team (NSSP or HIO) Accepted transport types MSH4.2 importance Submission frequency Key variables necessary for every message Data Validation Links on Meaningful Use website (technical specs, onboarding overview, etc) Overview of Data Validation Process Key Variables Message vs Visit- level validation Validation Phase Timeline Minimum 1 weeks worth of clean data before moving to production KDHE: Onboarding Process Establishing Connectivity Facility Reps work with Technical Representative; SyS Coordinator in attendance Register MSH4.2 value by updating facility sheet with NSSP Facility reps will work with technical team to establish connectivity Once connection has been established, facility will submit data regularly (at least once, daily) for one week Data Validation Download all data from a facility after a certain date (via phpmyadmin access) Run through SAS Program Outdated version available at: quality me for new version: fnaz@kdheks.gov Translate results into an SAS Program Example Outputs Hospital_Summary Hospital_RequiredFlaggedRecords Hospital_OptionalFlaggedRecords SAS Program Documentation Outdated Translate validation report Standard template; updated with results Onboarding Process: Disadvantages Time consuming! (Unnecessarily?) complicated process with basic procedures Data Validation Need for MUB to HL7 translation Facilities have difficulty finding trouble visits/messages Meaningful Use Stage 2: Current Onboarding Status Best Practices Schedule regular meetings (every 1-2 weeks) and set deadlines!
6 One person dedicated to onboarding/dq Lesson learned: For data quality, take your time to understand data early in the process Lesson learned: If you want usable data, you have to put in the time! Changes in the Future? Create/use database for tracking HIO (KHIN) assuming larger role Purchase specialized software Help with tracking status Maintain documentation Focus on data validation Decrease Onboarding Load = More time to add additional data sources Q&A Message types do you look at them? Do you look at them for missing diagnosis? Farah looks at all that are five days old doesn t validate using message type Next meeting: August 5, 2015, 3-4:30 pm ET Note: there will be no meeting in July due to the in- person Governance Group meeting.
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