PHRI+-+Child+Health+-+Dec+14+Minutes


 * Date: December 14, 2011**
 * Name:** Public Health Reporting Initiative - Child Health User Story Harmonization - Web Conference

**Meeting Minutes**
Reviewed the submitted documents from last week, including edits to the template spreadsheet. The first part of the call will be used to discuss and finish up with user story validation against the template spreadsheet. The second part of the call will be used to populate and discuss the child health consolidated user story (in the powerpoint slide template).

__Validation against Excel template discussion__ Changes to the excel spreadsheet were made during the call as directed. Pertinent comments/discussions are captured in the notes. PH Surveillance definition: ongoing, systematic collection, analysis and interpretation of outcome specific data for use in planning, implementation, and evaluation of public health practice. This can be applied to all child health user stories as the overarching goal. Note (for the Consolidated Use Case): The goal of the initial birth defect report is to 1) quantify the public health impact of birth defects, 2) monitor trends, 3) connect children in needs to care services, and 4) to enable evaluation of public health practices. Are these User Stories meant to capture the as-is process or the desired process using the EHR? Anna clarified that this should be what you want – if you’d like the machine component to imitate the current process, describe that process. If there is a process you are working towards, then describe that process. Agreement that EHR will streamline the process, but need to ensure that we are describing the appropriate triggers to report to Public Health – there is some element of back-end coding that must be done based on these triggers. It might be valuable to distinguish what is “ideal” vs. what is currently occurring on the ground. Reminder that only the initial report from EHR to public health is in scope for this initiative. Other workflows, data usage, etc. is currently out of scope but may be discussed as the initiative continues its work. Currently, the only source of some birth defect data is not a ‘checkbox’ in the EHR. Discharge data and admin/billing data is the way data is currently collected, but in the ideal world, the EHR would collect data elements related to birth defects that could be included in the public health report.

__Consolidated Child Health User Story__ The powerpoint slide template(s) for the Child Health User story were populated and edited as directed by workgroup discussion. Pertinent discussion points are captured in the notes. Actors: Clinicians/Nurses are not equivalent to birth information specialists. For the consolidated User Story, these groups will be combined into “hospital staff (nurse, birth information specialist)”. Flow of Events:
 * There is a different path for a live birth vs. a fetal death
 * Consent is not required for birth registration; birth registration is not a physician order (physicians order tests, immunizations, birth defect assessment, metabolic test, hearing test etc.)
 * Clarified language about initial birth defect assessment and additional birth defect testing
 * The “birth/fetal death facility worksheet” is used by everyone, but is not necessarily standard
 * Send/Receive is assumed to be electronic

__Next Steps__ The working set of powerpoint slide templates will be distributed to the group for comments and revisions. Please review and provide comments to Anna Orlova and Lindsay Brown by Friday, Dec 16, 2011.

__Parking Lot Items__ Recording the race of the child is currently left out of the medical record – the parent’s race is collected, but need to identify a linkage to establish the race of the child. (Note: this issue would appear in the ‘demographic’ data elements collected when the child is born – when the flow of events begins) Also – at the time of child demographic data collection, information about mom and dad is collected as well. How should this be represented in the flow of events and/or overall user story? Another challenge – sometimes the child medical record is included with the mother’s record at the time of birth. For example, fetal death may be recorded in the mother’s record but a live birth may produce a new record. On the ground at facilities, both the mother and child may be included in one record. Additionally, the pre-natal record may be hand-carried or electronically sent to the birthing facility (hospital, clinic, etc.)