HL7 Immunization User Group Monthly Meeting February 14, 2019 2:00 PM ET
Agenda ▪ Welcome ▪ Poll: Which perspective do you primarily identify yourself with? ▪ Submit an abstract for the AIRA 2019 National Meeting by February 24. ▪ Updates ▪ SISC ▪ Presentations ▪ Acknowledgements to Identify Data Quality Issues ▪ Client Completeness
SISC Update Mary Woinarowicz
Acknowledgments to Identify Data Quality Issues Kevin Snow, Envision
Jan 2019 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)
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)
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)
High Priority accuracy validation BR-116 : Manufacturer and CVX Code should not contradict one another Not Implemented Was unsure how to implement due to: • How to address case of manufacturer buys out another manufacturer. Does the code change? Do we need history of this to allow multiple values? Is there a challenge with keeping this up to date? Functional Guide Vol 2-Review Draft 1.7.19.docx
High Priority accuracy validation BR-118 : Vaccination Encounter Date should not be after the lot number expiration date HL7 Data Quality Statement AIRA-DV-BR-118: RXA-3 (DateTimeStartOfAdministration) should not be after RXA-16 (SubstanceExpirationDate) 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 2001 ^Conflicting Administration Date and Expiration Date^HL70533 (HL7ErrorCode)
Medium Priority accuracy validation BR-119 : Route and Site should not contradict each other for a given Vaccine Type and Patient’s age HL7 Data Quality Statement AIRA-DV-BR-119: RXR-1 (Route) and RXR-2 (AdministrationSite) contradict each other for the given Vaccine Type in RXA-5 (AdministeredCode ) and Patient’s age on RXA -3 (DateTimeStartOfAdministration) 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 3 ^Illogical Value error^HL70533 (HL7ErrorCode)
High Priority accuracy validation BR-121 : Administered vaccinations coded with an “unspecified” CVX code (should have specific Vaccine Types, e.g., Hib PRP-OMP; unspecified vaccine types, e.g., Hib, unspecified formulation) HL7 Data Quality Statement AIRA-DV-BR-121 : RXA-5 (AdministeredCode) should not be valued with an “unspecified” vaccine when the first occurrence of RXA -9.1 is valued "00" and 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 3 ^Illogical Value error^HL70533 (HL7ErrorCode)
High Priority accuracy validation BR-130 : Doses should not be recorded as given before the minimum patient age or after the maximum patient age for that particular vaccine HL7 Data Quality Statement AIRA-DV-BR-130 : Patient's age on RXA-3 (DateTimeStartOfAdministration) should not be before the minimum patient age or after the maximum patient age for the given Vaccine Type in RXA-5 (AdministeredCode) 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 Next slide…
BR-130 cont. When the above data quality statement is violated then return ERR-3 3 ^Illogical Value error^HL70533 (HL7ErrorCode) ERR-7 NumericPath: RXA[1].3[1].1, NamePath: (DiagnosticInfor ORDER[0]/RXA/DateTimeStartOfAdministration/Time, RuleId: , mation) ApplicationErrorCode: AIRA-DV-BR-130, AIRA Data Validation Guide Rule: BR 130, Maximum Date: 20180101, Administration Date: 20181217, Days Difference: 350 ERR-8 RXA-3 (DateTimeStartOfAdministration): Patient's age on this date (UserMessage) should not be before the minimum patient age or after the maximum patient age for the given Vaccine Type in RXA-5 (AdministeredCode) when RXA-20 (CompletionStatus) is valued "CP" or "PA" and RXA-21 (ActionCode) is not valued "D". Please see BR-130 in the AIRA Data Validation Guide.
Test and Document Like Crazy
Client Completeness Shannon Coleman, STC Michelle Middaugh, STC
22 Client Completeness Shannon Coleman and Michelle Middaugh Scientific Technologies Corporation STC | IDEAS START HERE
23 How does patient and vaccination information get into IWeb? User Interface Electronic Interface STC | IDEAS START HERE
24 STC Data Quality Summit February 12-13, 2019 Attendees: Client Interoperability experts, AIRA representatives and STC staff Purpose: Discuss data quality challenges, best practices Bad Merges/Duplicate Records ○ Address Cleansing ○ Homeless Populations ○ Patient Active/Inactive Status & Patient ○ Ownership ○ STC | IDEAS START HERE Programmatic
25 Opportunity to align with national guidance IIS DATA QUALITY PRACTICES TO MONITOR AND EVALUATE DATA AT REST STC | IDEAS START HERE
26 Where do you start? STC | IDEAS START HERE
27 It’s hard to assess any other dimension if the data isn’t being recorded in the registry in the first place. STC | IDEAS START HERE
28 Considerations for Completeness Does IWeb store the data element? • Is it a required data field in the UI? • Can it be required? Is it technically possible? • Is the data element required via HL7? • Does my issue resolution and import profile support the • expected conformance? Policies and Local decision-making: Should it be mandatory • for our providers? Does conflict exist between PHC Hub and IWeb? • STC | IDEAS START HERE
29 Client Completeness Configuration HL7 Crosswalk For each Data Element Corresponding HL7 field • Conformance from HL7 Implementation Guide • Conformance from Local HL7 Implementation Guide • Current settings within IWeb • Current Import Profile and Issue Resolution settings within • PHC Hub STC | IDEAS START HERE
30 HL7 Crosswalk STC | IDEAS START HERE
31 Client Completeness Configuration Report Card Establishes baseline by measuring completeness for Patient • Demographic and Vaccination Event Data Elements Benchmarks against Target Level established by Data at • Rest Guidance Indicates optimal configuration of current functionality • Identifies possible areas of conflict or inconsistency • Provides actionable recommendations to improve • completeness measures STC | IDEAS START HERE
32 Client Configuration Completeness Report Card STC | IDEAS START HERE
33 STC | IDEAS START HERE
34 STC | IDEAS START HERE
35 STC | IDEAS START HERE
36 STC | IDEAS START HERE
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