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ILHIE Public Health Work Group - Use Cases Subcommittee July 14 2010 Meeting Minutes 

July 14, 2010
10 a.m. - 11 a.m.

Attendees:

  • Steve Seweryn, Cook County Department of Public Health
  • Mary Driscoll, Illinois Department of Public Health (IDPH)
  • Peter Eckart, Illinois Public Health Institute (IPHI)
  • Mike Jones, Illinois Department of Healthcare and Family Services (HFS)
  • Jessica Ledesma, IDPH
  • Miriam Link-Mullison, Jackson County Health Department
  • Jeffrey Swim, DuPage County Health Department

Office of Health Information Technology (OHIT):

  • Mark Chudzinski
  • Krysta Heaney

Mary Driscoll opened the call at 10 a.m.

Mary proposed the group discuss: the type of work product used to provide recommendations to the Illinois Health Information Exchange (HIE) Advisory Committee, apply a timeline to the objectives identified in the Public Health Work Group (PHWG) Work Plan, and a regular schedule for this subcommittee to follow.

Steve Seweryn suggested the group begin by reviewing the PHWG Mission Statement and Work Plan with an emphasis on the tasks assigned to this subcommittee in order to determine the overall goals of the group. Peter Eckart recommended the group decide on more specific terms for each of the identified tasks, with the intent of developing a project plan spanning the next year. Peter distributed a use case example from New York as an example for the group's goals and deliverable.

There was consensus that clearly defining public health use and business cases would help determine how public health responds to the HIE, in both requesting and accessing data from the HIE.

The group discussed various methods for identifying and prioritizing use and business cases, including specifying the definitions of each.

  • Use Case: Information flow or process.
  • Business Case: Justification for data use/access.

Steve suggested focusing on the requirements as defined under meaningful use (immunizations and communicable disease reporting) as an initial starting point. This opinion was echoed by the group.

Mary suggested developing a general use case regarding accessing HIE data while allowing for the data, features particular to public health needs, e.g., de-identified data.

Miriam Link-Mullison underscored the importance of communicating the value of public health data use as a component of the business case. Mary expanded on this concept, citing immunizations as an example of public health data that leads to an intervention.

Mike Jones recommended prioritizing use cases based on how they relate to the pubic health's core functions and essential services, as well as looking at how the HIE will affect the public health performance standards.

Miriam suggested another criterion for use case selection should be the quality improvement monitoring occurring at the local level, especially since certain measures (e.g., HbA1c) are part of the meaningful use objectives.

Mike indicated that this what the MEDI system does at HFS. The MEDI system allows physicians to evaluate care performance for specific patient populations, and across physicians locally and nationally to improve care. Mike also suggested leveraging the state/federal capacity to adjust payments based on quality measures.

Steve provided some background information on the Cook County Health Department's application for a Chicago Community Trust grant to assess ambulatory care safety-net access and capacity in Cook County. The program establishes a system to collect data (already submitted to the feds) on safety-nets similar to the 2003 and 2007 work conducted by the City of Chicago. To avoid duplication of efforts, Cook County is revising the proposal to include components of HIE and heath reform that can be used to monitor healthcare access for low income and indignant individuals in safety-net ambulatory care service settings.

Mary shared with the group an interesting point raised during the Core Public Health Requirements for Interoperability subcommittee call. Bill Trick brought, to the attention of the group, the need for public health be able to abstract data elements from the HIE in ways that allow public health to access the information they need – indicating the public health may need to develop the technical architecture that allows public health to draw down the data.

There was a discussion about at what points in the system data standardization will occur (at the provider, HIE, or public health level). Mary indicated that vendors have the ability to take qualitative data, like progress notes, and abstract that data – looking to the HIE to develop these functions or express the expectation that vendors develop the appropriate capabilities. Mike mentioned some of these specifications may be addressed in the certification process.

Peter suggested a five-step process for selecting use cases.

The process, and initial suggestions, for selecting use and business cases for public health functions within HIE development, is as follows:

  1. Brainstorm list of possible public health use cases
    1. Communicable disease reporting
    2. Immunizations
    3. Electronic lab reporting
    4. Quality monitoring
    5. HAI (e.g., chart reviews)
    6. Cook County Health Department grant from the Chicago Community Trust to develop ambulatory care access / capacity surveillance system (revised to develop one or multiple use cases)
  2. Develop criteria for prioritizing which use cases to
    1. Meaningful Use objectives
    2. Other payment incentive programs
    3. National Public Health Performance Standards
    4. Public health core functions and essential services
    5. Illinois State Health Improvement Plan
    6. Illinois health department I-PLANs
    7. Existing reporting mandates
    8. Data likely to be included in early-stage HIE (state, local, and enterprise)
    9. Data that is/will be available
    10. Data that has current activity or functionality
    11. Public health elements of functioning HIEs
    12. Data that public health would like collected/access to
    13. Use Case development funding opportunities
    14. Partners to share or do work of use case development
  3. Select / Establish priorities
    1. Research existing public health use cases – literature review concurrent with above activities
      1. Statewide Health Information Network for NY (SHIN-NY) HIE for Public Health Use Case, NY state (undated)
      2. Quality – Draft detailed use case, ONC (2007)
      3. Public Health Case Reporting, ONC (2008)
      4. Business Case for Public Health Participation in Health Information Technology Standardization, PHDSC (2009)
      5. Other use case-like processes
        1. MTA "use case" plans at MCHC
        2. Business process analysis done at MTAs 2, 4, and 11
    2. Post to HIE Wiki at http://illinois-hie.wikispaces.com/PublicHealth
  4. Develop public health use cases (adapt existing, create new)
    1. Who will do this significant work?
    2. Who will pay for it?

Peter will post the three public health use cases to the ILHIE wiki, the group will familiarize themselves with the documents for the next meeting, scheduled for Wednesday, July 28, 2010, from 10 - 11 a.m.

Meeting Adjourned at 11 a.m.