Data Element
Hearing loss risk indicators
Description

Documentation of specific hearing loss risk indicators for the newborn.
Submitted By: Craig Newman / Altarum
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.
Estimate the breadth of applicability of the use case(s) for this data element 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
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
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.
Extent of exchange 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 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
Criterion #1
Maturity - Current Standards		 Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3
Maturity - Current Exchange		 Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 0 - Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.

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