| Submitted By: Craig Newman / Altarum | |
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| Data Element Information | |
| Use Case Description(s) | |
| Use Case Description | Initial screening is the first step in providing services and support to affected individuals. The first goal of EHDI programs is to screen all newborns for hearing loss before 1 month of age. Any infants who screen positive, need to have a diagnostic evaluation before 3 months of age. Another goal of EHDI programs is to connect all infants identified with hearing loss to appropriate early intervention services before 6 months of age. Having access to the initial screening results at the time of birth is crucial for EHDI follow up programs to provide services in a timely fashion. Today, much of this data is collected via fax and other manual workflows. |
| Estimated number of stakeholders capturing, accessing using or exchanging | Hearing screening should be performed for each of the nearly 4,000,000 infants born in the United States each year. Data is shared with the local Public Health Early Hearing Detection and Intervention (EHDI) program in all states and territories. |
| Healthcare Aims |
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| Maturity of Use and Technical Specifications for Data Element | |
| Applicable Standard(s) | 58232-0 - Hearing loss risk indicators (including Preferred Answer List LL862-4) |
| Additional Specifications | Version 2.6 EHDI Results implementation guide published by HL7 http://www.hl7.org/implement/standards/product_brief.cfm?product_id=344 Relevant US Core FHIR resources |
| Current Use | This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders |
| Supporting Artifacts |
All state EHDI programs already capture this data today, it's just mostly a manual or paper workflow. The state of Oregon is receiving electronic data from at least one hospital site. |
| Number of organizations/individuals with which this data element has been electronically exchanged | N/A |
| Potential Challenges | |
| Restrictions on Standardization (e.g. proprietary code) | none |
| Restrictions on Use (e.g. licensing, user fees) | none |
| Privacy and Security Concerns | Parents may opt out of screening. |
| Estimate of Overall Burden | This data is being collected by EHRs and/or devices today, but there is very little support for electronic exchange of the data. Vendors would need to support electronic data exchange (either as a v2 message or by exposing the Observations necessary to convey the data elements). Development would also be needed on the Public Health side to receive the data electronically or to query for it. The use of v2 messaging would require some implementation effort by the submitting hospital site as workflows which trigger sending data would need to be validated and tested. The use of FHIR API to query for data would reduce the implementation burden on hospitals but would make the Public Health workflow more complicated. |
| ONC Evaluation Details Each submitted Data Element has been evaluated based on the following 4 criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI |
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| Maturity – Standards/Technical Specifications | Level 1/2 - Must be represented by a vocabulary standard or an element of a published technical specification |
| Maturity - Current Use | Level 2 - Used at scale in more than 2 different production environments |
| Maturity - Current Exchange | Level 2 - Demonstrates exchange between 4 or more organizations with different EHR/HIT systems |
| Breadth of Applicability - # Stakeholders Impacted | Comment Level - Used by few stakeholders, or for narrowly defined conditions or events |
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