Early Hearing Detection and Intervention-Hearing Plan of Care
EHDI-HPoC EHDI Hearing Plan of Care communicates care plan information to assist early detection, and document interventions for hearing loss.
In the EHDI Profile, the Hearing Plan of Care document (HPoC) describes the content needed to communicate care plan instructions to properly manage the detection and intervention of hearing loss in newborns and young children.
THIS PROFILE REPLACES THE EARLIER PROFILE CALLED Early Hearing Care Plan (EHCP) Profile. 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 EHDI profile assists with detection, documentation of and intervention for hearing loss through a Hearing Plan of Care (HPoC) made available to all authorized care providers as jurisdictionally directed by the Public Health EHDI program. The HPoC document provides 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 care and EHDI Public Health Programs 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 HPoC document is implemented and the actions to be taken by providers following receipt of the care plan from the EHDI program.
- 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
The EHDI-HPoC 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 the following sections of information:
- Plan of Care: 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. A sub-set of active problems relevant to hearing care is used to identify conditions associated with the newborn that are typically pertinent to the hearing plan of care (e.g., baby has atretic ear, birth defect).
- History of Procedures: A list of the procedures performed on the newborn. A sub-set of procedures relevant to hearing care is used to identify procedures performed on the newborn that are typically pertinent to the hearing plan of care (e.g., baby had a cleft pallet repair).
Actors & Transactions:
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Specification Trial Implementation
Documents: IHE QRPH Supplement EHDI
- HL7 Clinical Document Architecture (CDA® Release 2)
- Logical Observation Identifiers Names and Codes (LOINC®)
- Nomenclature Of Medicine Clinical Terms (SNOMED-CT)
- 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
A system which implements the HPoC 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 HPoC documents.
A system which implements the HPoC Content Consumer, such as a Clinical EHR system or a Public Health EHDI information (EHDI-IS), can receive or retrieve HPoC documents, and process HPoC documents, which includes the display and import of the document, and processing of structured data included in the documents.