HL7 FHIR® Implementation Guide: Making Electronic Data More Available for Research and Public Health (MedMorph) Reference Architecture, Release 1- US Realm

DESCRIPTION

The goal of the MedMorph project is to develop and pilot a scalable and extensible standards-based reference architecture. This reference architecture will enable clinical data exchange with electronic systems (e.g., EHRs) and public health systems, specialized registries, national health care survey systems, and research information systems for multiple conditions. The reference architecture outlined three priority use cases:

• Hepatitis C
• Cancer
• Health Care Surveys

The MedMorph project leveraged, where appropriate, existing FHIR resources and profiles, CCDS and USCDI definitions, and CQL to improve patient data exchange from different data source platforms to various receiving systems. The use of standards improve the timeliness and completeness of data collected by public health and research and reduce the burden on health care providers and patients.

There are some overlaps in current HL7 projects such as the CDA STU Public Health electronic Initial Case Report (eICR) and FHIR Electronic Case Reporting (eCR) in HL7 PSS #136. These projects focus primarily on an 1) initial case report for reportable conditions, 2) a bidirectional communications transaction, the Reportability Response, and 3) a specification (the electronic Reporting and Surveillance Distribution (eRSD)) to help automate reporting. MedMorph leveraged this work and the work of the FHIR Common Reporting Framework and expand the focus to include research and chronic reporting.

This FHIR implementation guide used US Core profiles as needed and appropriate.

ALTERNATIVE NAMES

HL7 FHIR® Implementation Guide: Making Electronic Data More Available for Research and Public Health (MedMorph) Reference Architecture, Release 1- US Realm may also go by the following names or acronyms:

BENEFITS

• Provides a framework that can be applied to multiple use cases that reduces burden on providers
• Leverages the maturation of standards and requirements for certification of health information technology for developing standards-based scalable and extensible solutions to overcome interoperability challenges

 

IMPLEMENTATIONS/CASE STUDIES

Pilot for

• Chronic Hepatitis C Surveillance (NY City Department of Health and Mental Hygiene (DOHMH),
• MDLand,
• and two healthcare organizations that use MDLand).

DEVELOPMENT BACKGROUND

The HL7 FHIR Standard has been used by healthcare application implementers across the globe, drawn by its ease of use. FHIR is a landmark step to remove many of the barriers to healthcare data exchange.

The Making Electronic Data More Available for Research and Public Health (MedMorph) project seeks to use emerging health data and exchange standards, namely Health Level 7 (HL7®) Fast Healthcare Interoperability Resources (FHIR®), to develop and implement an interoperable solution to enable access to clinical data. The MedMorph project fits within the Centers for Disease Control and Prevention (CDC) strategic imperative of transforming how data are collected, used, and shared through modern Information Technology (IT) capabilities to save lives and improve health. The project aims to leverage the maturation of standards and requirements for certification of health information technology by the Office of the National Coordinator for Health IT (ONC) that underpin many electronic health data sources. ONC’s 2015 Edition Health IT Certification Criteria and the Cures Update include, but are not limited to, the United States Core Data for Interoperability (USCDI) Version 1 and the use of standardized application programming interfaces (API) for patient services (such as FHIR R4 and Bulk FHIR APIs). Broader implementation of these certification criteria has created a health IT environment ripe for developing standards-based scalable and extensible solutions to overcome interoperability challenges. The MedMorph Reference Architecture (RA) IG refers to a common framework (e.g., actors, systems, FHIR resources, FHIR APIs, FHIR operations, security mechanisms) leveraged by multiple use cases. The MedMorph RA IG is accompanied by content IGs, which provide content profiles pertaining to a specific use case. Requirements for specific use cases are driven by the content IGs whereas the requirements for the framework components, such as the Health Data Exchange App (HDEA) (MedMorph’s backend services app), Knowledge Artifact Repository (KAR), Trusted Third Party (TTP), etc., are identified as actors in the MedMorph RA. The MedMorph RA provides a framework that can be applied to multiple use cases that reduces burden on providers.

 

RELATED DOCUMENTS

HL7 FHIR® Implementation Guide: Making Electronic Data More Available for Research and Public Health (MedMorph) Reference Architecture, Release 1- US Realm

STU DOCUMENTS

HL7 FHIR® Implementation Guide: Making Electronic Data More Available for Research and Public Health (MedMorph) Reference Architecture, Release 1- US Realm See the standard at http://hl7.org/fhir/us/medmorph/STU1.

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TOPIC

• Public Health

BALLOT TYPE

• STU

STATUS DATE

2023-06-08

RESPONSIBLE WORK GROUP

PRODUCT TYPE

• Implementation Guide

STAKEHOLDERS

• Clinical and Public Health Laboratories
• Clinical Decision Support Systems Vendors
• EHR, PHR Vendors
• Health Care IT Vendors
• Healthcare Institutions
• Immunization Registries
• Lab Vendors
• Local and State Departments of Health
• Pharmaceutical Vendors
• Quality Reporting Agencies
• Regulatory Agency

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm