HL7 Immunization User Group Monthly Meeting February 13, 2020 - PowerPoint PPT Presentation

HL7 Immunization User Group Monthly Meeting February 13, 2020 2:00 PM ET

Agenda • Welcome - Which perspective do you primarily identify yourself with? • Updates • SISC • FHIR • Five on FHIR • Error Code Review • Review of Guidance • Implementation Demonstration • M&I Testing for Error Handling • HL7 FAQ

SISC Update Heather Patrick

FHIR Update Nathan Bunker

FHIR Update • HL7 met in Sydney Australia • Work continues on FHIR r5 • Pre-R5 milestone 4.2.0 released at Sydney Connetathon • Upcoming meetings: • Mar 19-13, 2020 – HIMSS20 HL7 Booth #2921 – Orlando FL • May 16-22, 2020 – WGM & FHIR Connectathon – San Antonio TX • Jun 16-18, 2020 – HL7 FHIR DevDays – Cleveland OH • Sep 18-25, 2020 – WGM & FHIR Connectathon – Baltimore MD • Jan 16-22, 2021 – WGM & FHIR Connectathon – Henderson NV

Five on FHIR Nathan Bunker

Immunization Decision Support • Working group under HL7 Public Health (PH) Work Group • Meet every week, Friday 11 am ET • Proposals are brought to PH for discussion and approval • Creating an implementation guide to: • Provide standard integration with CDS engines • Create common interface for FITS to test CDS engines • Learn how to publish FHIR guides • Current guide can be found here: • http://build.fhir.org/ig/HL7/ImmunizationFHIRDS/index.html

EHR Query to IIS

IIS User Inter- face

Public Health Function

Progress and Next Steps • Project Phase 1: Healthy Child, Adolescent, and Adult • Ballot completed, all comments have dispositions • Updating the Implementation Guide • Will start process for publication soon • Looking to demonstrate at September Connectathon in Baltimore • FITS will be implementing support later this year • Project Phase 2: Special Conditions • Starting discussions now

Error Code Set Review: Review of Guidance Tracy Little

Error Code Guidance Developed following publication of the HL7 2.5.1 rel. 1.5 IG The ERR segment is used to exchange error related data: • ERR-2 (Error Location) location of the error in the incoming message. • ERR-3 (HL7 Error Code) indicates the nature of the HL7 (communication) error. • ERR-4 (Severity) indicates if the error code being returned is informational, a warning or an error. • ERR-5 (Application Error Code) indicates the nature of the error that occurred. • ERR-8 (User Message) transmits a text to further explain the nature of the error. Companion spreadsheet: Compiled Error Codes

Compiled Error Codes Spreadsheet Tracks expanded details for two error code • sets: HL70357 and HL70533 HL70357 is the HL7 Error Codes table for • Where to find this format or technical type errors. This table is “HL7 Defined” and cannot be amended or guidance: expanded. Natio ional S Set of of Err Error Cod Codes • HL70533 is the Application Error Codes table • Compile mpiled E Error Codes • for clinical or administrative type errors related to data reported. This table is a “User Repository keywords: error codes Defined” HL7 table and can be expanded.

Application Error Codes • Initially 7 codes in the table Codes are categorized by class Existing (error codes documented in • Release 1.5) • Expanded to over 60 codes Conflicting Data (data within a single • message is internally inconsistent) Inappropriate Date • • As you think about Invalid Data • updating/expanding your Lookup (an expected record cannot be • found based on data in the message) system’s use of application Message Construction (structural issues • error codes, start here. based on local business rules) Leverage what has already Missing Data • been added if it meets your Processing Error • needs. Data Sharing •

Further guidance to support sending errors, generating ERR segments Guida idance ce f for or HL7 HL7 A ACK CK Messages to Support I Interoperabilit ility Repository keyword: ACK

Error Code Set Review: Implementation Demonstration Kevin Snow

Jan 2019 Feb 2020 HL7 Data Quality Harmonizing HL7 Validation with the AIRA Data Validation Guide and National Error Code Set Guidance

Completeness Timeliness Consistency Accuracy Validity

The 5Ws (and H) • The IIS Who • Implement or harmonize with existing data accuracy checks and error codes What Where • HL7 Response Messages When • In real time • Quick to find, quick to fix. Easier when in harmony with existing resources. Why • …and request for feedback! How

Resources Used https://immregistries.org/resource/

High Priority accuracy validation BR-101 : Vaccination Encounter Date must not be before Patient Date of Birth HL7 Data Quality Statement AIRA-DV-BR-101 : RXA-3 (DateTimeStartOfAdministration) must not be before PID-7 (DateTimeOfBirth) when RXA-21 (ActionCode) is not valued "D“. When the above data quality statement is violated then return ERR-3 2204 ^Vaccination Date Too Long Ago^HL70533 (HL7ErrorCode)

Example Submit a vaccine the day before the DOB MSH|^~\&|TestApplication|KS9999|WebIZ|KS0000|20060201000000||VXU^V04^VXU_V04|KS99 9938854000000232|T|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||000000002^^^KS9999^MR||SIMPSON^BART^M^^^^L||19990101|M ORC|RE||9999^KS0000 RXA|0|1|19981231||45^hep B, unspec^CVX|999|||01^historical^NIP001||^^^KS9999|||||||||CP|A Should yield ERR||RXA^1^3^1^1|999^ApplicationError^HL70357|E|2204^Vaccination Date Too Long Ago^HL70533^AIRA-DV-BR-101^Vaccination Encounter Date must not be before Patient Date of Birth^L||NumericPath: RXA[1].3[1].1, NamePath: ORDER[0]/RXA/DateTimeStartOfAdministration/Time, RuleId: 148, ApplicationErrorCode: AIRA-DV- BR-101, AIRA Data Validation Guide Rule: BR 101| RXA-3 (DateTimeStartOfAdministration): must not be before PID-7 (DateTimeOfBirth) when RXA-21 (ActionCode) is not valued "D". Please see BR-101 in the AIRA Data Validation Guide.

High Priority accuracy validation BR-103 : Vaccination Encounter Date must be less than or equal to (before or the same as) the Submission Date HL7 Data Quality Statement AIRA-DV-BR-103: RXA-3 (DateTimeStartOfAdministration) must be less than or equal to (before or the same as) MSH-7 (DateTimeOfMessage) when RXA-21 (ActionCode) is not valued "D". When the above data quality statement is violated then return ERR-3 1 ^Illogical Date error^HL70533 (HL7ErrorCode)

Example Submit the following MSH|^~\&|TestApplication|KS9999|WebIZ|KS0000|20060201000000||VXU^V04^VXU _V04|KS999938854000000232|T|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||000000002^^^KS9999^MR||SIMPSON^BART^M^^^^L||19990101|M ORC|RE||9999^KS0000 RXA|0|1|20291231||45^hep B, unspec^CVX|999|||01^historical^NIP001||^^^KS9999|||||||||CP|A And you should see the following somewhere in the response ERR||RXA^1^3^1^1|999^ApplicationError^HL70357|E|1^Illogical Date error^HL70533^AIRA-DV-BR-103^Vaccination Encounter Date must be less than or equal to (before or the same as) the Submission Date^L||NumericPath: RXA[1].3[1].1, NamePath: ORDER[0]/RXA/DateTimeStartOfAdministration/Time, RuleId: 73, ApplicationErrorCode: AIRA-DV-BR-103, AIRA Data Validation Guide Rule: BR 103| RXA- 3 (DateTimeStartOfAdministration): must be less than or equal to (before or the same as) MSH-7 (DateTimeOfMessage) when RXA-21 (ActionCode) is not valued "D". Please see BR-103 in the AIRA Data Validation Guide.

High Priority accuracy validation BR-107 : Every administered vaccine should be recorded as a single Vaccination Event (e.g., combo vaccine should be recorded as 1 event rather than separate events for each component) Not Implemented Was unsure how to implement due to: • Immunizations can be split into multiple messages • Even if it’s in a single message the components could be out of order

High Priority accuracy validation BR-114 : Vaccination Encounter Date should not be the same as the Patient Date of Birth unless it is on the list of vaccines recommended for administration on the date of birth, e.g., HepB HL7 Data Quality Statement AIRA-DV-BR-114 : RXA-3 (DateTimeStartOfAdministration) should not be the same as PID-7 (DateTimeOfBirth) unless it is on the list of vaccines recommended for administration on the date of birth, e.g., HepB when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D“. When the above data quality statement is violated then return ERR-3 1 ^Illogical Date error^HL70533 (HL7ErrorCode)