Early Hearing Detection and Intervention-Workflow Document

This IHE Early Hearing Detection and Intervention-Workflow Definition (EHDI-WD) profile specifies a standard workflow to orchestrate the collection and exchange of data between clinical and program-specific public health information systems.

Part of the Early Hearing Detection and Intervention - Family of Profiles.

Summary

This IHE Early Hearing Detection and Intervention-Workflow Definition (EHDI-WD) profile specifies a standard workflow to orchestrate the collection and exchange of data between clinical and program-specific public health information systems. It defines a document-based workflow where multiple systems from different organizations can participate in producing a document or set of documents which record a patient’s history of care and support care planning and decision making. The purpose of the EHDI-WD profile is to improve the way newborn hearing screening information is tracked and shared between clinical care and public health. Automation of the Hearing Plan of Care is intended to improve health outcomes for children at risk for hearing loss. The EHDI-WD profile builds upon several other IHE profiles. It utilizes actors and transactions established by the IHE ITI Cross-enterprise Document Workflow (XDW) profile. The XDW profile builds upon the document sharing mechanisms defined in the IHE ITI Cross-enterprise Document Sharing profile.

Benefits

• Ensure that the newborn hearing screening process is performed consistently
• Standardize screening practices and hearing care planning for all infants
• Provide interoperability between clinical EHRs at hospitals, doctor’s offices, and EHDI programs, for increased efficiency, better data quality, and better coordination of care

Details

This IHE Early Hearing Detection and Intervention-Workflow Definition profile specifies a standard workflow which covers the period of time from birth to the point where the newborn is discharged from the birthing facility.

The EHDI-WD process, orchestrates the creation of documents by systems which contribute data used to develop a newborn’s hearing plan of care.

The EHDI-WD profile specifies the type of information that various systems must contribute, and the order in which it can be collected, in order to produce a complete and accurate hearing plan of care. The hearing plan of care includes newborn demographic information from a system that can share this data at the point of birth. It includes screening results information from a system that can communicate data generated by hearing screening devices. It includes screening outcome information from a system that can apply assessment guidelines and determine how a set of screening results are interpreted for the purpose of care planning. It also includes other data gathered a system that produces a care summary generated at the point of discharge. The EHDI-WD profile ensures that a complete and consistent hearing plan of care document is available for the infant’s primary care provider, or other specialists to receive or access.

The EHDI-WD profile specifies a Workflow Document which tracks and informs the flow of data collection and processing. The data in the EHDI Workflow Document can be utilized to efficiently monitor and analyze the hearing screening process for each newborn.

The EHDI-WD profile does not define any new transactions.

Systems Affected

Actors & Transactions:

Table 1-1 lists the workflow participant actors defined in the EHDI-WD profile.

Figures 1-4 through 1-6 show the structure and content of the EHDI-WD Workflow Document as the tasks in the workflow are initiated and completed. Each numbered panel shows the content in the Workflow Document at a subsequent point in time. For example, Panel number 1 shows the creation of the Workflow Document which initiates the process, and then panel number 2 shows the content of the Workflow Document at the conclusion of that first task. Note: The figure is depicted in three parts due to its extended size. The panel numbers can be cross-referenced in the sequence diagram shown in figure X.4.2.1.2-1 of the EHDI-WD profile.

Actor Options For each workflow participant actor, EHDI-WD defines a realm-based Actor Option. The realm-based actor option is used to connect the actor with a specific type of content document for creation or consumption in that jurisdiction. The binding of specific content documents to the EHDI-WD US Realm actor options are defined in volume 4 of the profile. Table 1-4 lists the document types define by EHDI-WD.

Actor Groupings Actor grouping mechanisms in a workflow definition profile are complex. Each workflow participant must be grouped with actors from the ITI XDW profile. These groupings specify each workflow participant’s capabilities for interacting with the workflow document content module. Also, each workflow participant may be grouped with actors from specific Content Profiles. The grouping with Content Profile actors provides the needed capabilities to create and consume the input and output documents that trigger the flow of information processing in a document-based workflow.

Specification

Profile Status: Trial Implementation

IHE PCC Supplement EHDI-WD

Underlying Standards:

• Cross-Enterprise Document Workflow (ITI XDW)
• HL7 Clinical Document Architecture (CDA® Release 2)
• HL7 QRDA IG July 2012
• Logical Observation Identifiers Names and Codes (LOINC®)
• Systematized 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 Plan of Care Manager actor, such as a Public Health EHDI Information system (EHDI-IS), Health Information Exchange system (HIE), or Electronic Health Records system (EHR), can create, consume and update EHDI-WD Workflow Documents. They also can create and update Hearing Plan of Care documents.

A system which implements the Screening Requestor actor, such as a Public Health EHDI Information system (EHDI-IS), Health Information Exchange system (HIE), or Electronic Health Records system (EHR), can consume and update EHDI-WD Workflow Documents. They also can create Screening Outcome Reports.

A system which implements the Order Placer actor, such as an integrated EHDI application or Electronic Health Records system (EHR), can consume and update EHDI-WD Workflow Documents. They also can consume Order Request documents, and create hearing screening Result Report documents.

A system which implements the Care Summary Generator actor, such as an Electronic Health Records system (EHR), can consume and update EHDI-WD Workflow Documents. They also can create Care Summary documents.

This page is based on the Profile Overview Template