Early Hearing Care Plan

The Early Hearing Care Plan (EHCP) Profile describes the content needed to communicate care plan instructions to properly manage the detection and intervention of hearing loss in newborns and young children.

Summary

THIS PROFILE HAS BEEN DEPRECATED

Early Hearing Detection and Intervention (EHDI) is a United States-based (US) public health program that directs hospitals to screen newborns for hearing loss prior to hospital discharge. The EHCP profile will assist detection, documentation of and intervention for hearing loss through an Early Hearing Care Plan (EHCP) made available to all authorized care providers as jurisdictionally directed by the Public Health EHDI program. The EHCP will provide best practice hearing guidance on next steps and actions that must be initiated for each newborn following discharge from the hospital nursery. It includes clinical content pertinent to EHDI such as screening results, risk indicators for hearing loss, interventions, and most importantly care plan instructions for management of the patient. This content profile will describe how the EHCP is to be implemented and the actions to be taken by providers following receipt of the care plan from the EHDI program.

Benefits

• Ensure that newborn hearing screening results and other relevant clinical information are consistently communicated to care providers
• Standardize care coordination for infants with suspected hearing loss
• Provide interoperability between clinical EHR and EHDI for increased efficiency and better data quality

Details

The EHCP content profile specifies how to use the HL7 CDA Standard to share information relevant to a newborn’s early hearing plan of care as defined by the jurisdiction Public Health Authority. This includes:

EHCP document contains the following sections of information:

• Treatment Plan: This section describes the appointments, referrals, treatments, diagnostic orders, and interventions necessary to conform to the jurisdiction public health authority directed guidelines under the plan. This includes resources to perform these procedures (e.g. JCIH statement URL), task lists, and instructions to the provider for follow-up care expressed as jurisdictionally defined free-text, and possibly coded values if available.

• Hearing Screening Coded Results: This section contains machine readable structured data for the patient’s relevant studies, e.g. the hearing screening method and results, as well as the screening outcome assessment. Where the screening results are not available, the reason the results are not available SHALL be present.

• Risk Indicators for Hearing Loss: Risk indicators for hearing loss identified through review of systems, family /social history, and/or physical examination details, as well as any necessary assessments of functional status or risks to the patient.

• Active Problems: Any diagnoses based on assessments, diagnostic results, and other information received from other providers. This is a list of conditions associated with the newborn that will inform the assessment of risk (e.g., baby has atretic ear, birth defect).

• Physical Exam: Aspects of the physical exam related to hearing screening or risk indicators for hearing loss.

• Review of Systems: A narrative description of the responses the patient gave to a set of routine questions on the functions of each anatomic body system.

Procedures and Interventions: This section documents that hearing screening procedure was performed. If the procedure is not performed, the reason is indicated. This section also includes procedures that MAY contribute to risk indicators for hearing loss and procedures that have been performed that refer the patient for follow-up care for hearing loss. Where hearing referral cannot be obtained, this reason for no referrals or follow-up interventions is also documented in this section.

Systems Affected

Actors & Transactions:

Specification

Trial Implementation

Documents:

• IHE QRPH Supplement EHCP

Underlying Standards:

• HL7 Clinical Document Architecture (CDA® Release 2)
• Logical Observation Identifiers Names and Codes (LOINC®)
• Nomenclature Of Medicine Clinical Terms (SNOMED-CT)

See Also

Related Profiles

• Cross-enterprise Document Sharing for Imaging [XDS.b], Cross-enterprise Document Sharing Environment including
• Cross-enterprise Document Reliable Interchange [XDR] can be used to support a reliable messaging-based infrastructure for sharing EHCP documents between sites over a network
• Cross-enterprise Document Media Interchange [XDM] can be used to support a media-based infrastructure for sharing EHCP documents between sites over a network
• Patient Identifier Cross Referencing [PIX], Patient Demographics Query [PDQ], Notification of Document Availability [NAV], and Document Metadata Subscription [DSUB] can be used to support a registry/repository-based infrastructure for sharing EHCP documents between sites over a network

• Consistent Time [CT] and Audit Trail and Node Authentication [ATNA] are used to support security and privacy when sharing the EHCP documents between sites over a network

• Basic Patient Privacy Consents [BPPC] profile can be used to capture and communicate parental consents associated with the hearing screening workflow, and these should be included in the EHCP metadata.

• Document Digital Signature [DSG] can be used to assert the authoritative source of the care plan as public health.
• Sharing Value Sets [SVS] can be used to provide related value sets to the EHCP document

Systems Affected

A system which implements the EHCP Content Creator actor, such as a Public Health EHDI Information system (EHDI-IS), Health Information Exchange system (HIE), or Electronic Health Records system (EHR), creates and transmit EHCP documents.

A system which implements the EHCP Content Consumer, such as a Clinical EHR system or a Public Health EHDI information (EHDI-IS), receives or retrieves EHCP documents, can receive or retrieve EHCP documents, and process EHCP documents which includes the display and import of the document, and processing the structured data included in the documents.

This page is based on the Profile Overview Template