Help public health improve health in your communities while meeting Centers for Medicare and Medicaid (CMS) Promoting Interoperability requirements for electronic case reporting (eCR)!
In this challenge (“the Challenge”) your goal is to collect and electronically report complete case information from healthcare to public health agencies (PHAs) so they can better prepare for, and respond to, health concerns in their jurisdictions1. Successful participants will meet CMS Promoting Interoperability requirements for eCR and Challenge data elements support the Cures Act and proposed U.S. Core Data for Interoperability (USCDI) V3 requirements. Awardees can receive up to $150,000!
The Challenge Requirements:
- Implement the collection of key, coded work information (see Occupational Data for Health (ODH) below) at one or more health care organizations (HCOs):
- Employment Status (as defined in the ODH information model). If the person has never worked, only collect Employment Status (See Work and Health Functional Profile (WHFP)).
- Job Occupation and Job Industry for current job(s). Include the most recent job(s) (last 12 months) if the patient is not currently employed.
- Usual (Longest-Held) Occupation and Usual Industry for all patients who have ever worked, regardless of current employment status or job. Usual work can span multiple jobs.
- Note: Participants are strongly encouraged to refer to The ODH Collection Guide for assistance implementing a successful collection strategy for occupation and industry values, including user interface suggestions and use of keyword searches.
- Implement the HL7 CDA electronic initial case report (eICR) R3.1 standard, with Reportable Conditions Knowledge Management System (RCKMS) and the Association of Public Health Laboratories (APHL) eCR AIMS platform, to send case reports to the appropriate PHA(s). The case reports must include these data coded using the value sets identified in the standard and correctly mapped into the R3.1 template:
- Collaborate with the points-of-contact for eCR and, as appropriate, occupational health, at the PHA(s) to ensure that reporting specifications are available in the RCKMS.
- Participants can receive a supplemental award by including silicosis case reporting where it is required by law.
- For a better score, also include Additional Challenge Data (below).
All Challenge materials must be submitted by midnight ET, Friday, November 17, 2023.
- Up to two awards of $125,000, each.
- Supplemental award! Awardees who fulfil the required Challenge criteria and have included silicosis case reporting will receive an additional $25,000.
Bonus! Sponsors from the National Institute for Occupational Safety and Health (NIOSH) will be available after the Challenge ends to consult about the use of patients’ work information for population health activities, such as assessing patient risk and opportunities for improving the health of workers. For example, patients’ work information as described by ODH (below) can be used to improve clinicians’ ability to recognize silicosis among patients at risk.
Award recipients must include at least one HCO (hospital, health system, and/or ambulatory practice). Awardees can be individual HCOs or teams, with members such as:
HCOs new to eCR or those who previously implemented eCR and now meet the Challenge requirements
Federally Qualified Health Centers, Health Center Controlled Networks, Primary Care Associations
Tribal and Territorial HCOs
Third party reporting organizations
All decisions of the Challenge Panel will be final. The Panel will consider:
- Data Completeness: Evidence of collection of all required challenge data (above) using the value sets and codes specified in the eICR R3.1 standard.
- The percentage or count of the documents sent that include the required challenge data (above) including analysis of correct and incorrect coding.
- Note: The ODH data collection methodology must support accurate collection of the data using the ODH value sets, while minimizing provider workflow disruption. Participants are strongly encouraged to review The ODH Collection Guide, for tips on interface wording and using a keyword search.
- Evidence of collecting and sending additional challenge data (below) can improve the participant’s score. The number of these elements included and the frequency of their presence using the specified value sets will contribute to scoring.
- Policy and Technical Compliance: Evidence of successful eCR processing through the APHL AIMS Platform using the eICR R3.1 standard.
- Communication/Collaboration with the Relevant PHA(s): Evidence of communication/collaboration with the eCR and occupational health programs’ points-of-contact, if applicable.
- Breadth of Impact:
- Evidence of using ODH (below) to implement collection of patients’ work information in one or more healthcare facilities.
- The size of your HCO will not impact your score.
Challenge Award Funding, Administration, and Rules
- All awards are made at the discretion of the Challenge Panel and the Panel decisions are final.
- Reporting must be from hospitals, health systems, and/or ambulatory practices in the United States and itsterritories2.
- Participants can implement eCR where it has not been done before OR update from a previous eICR standard. The eICR R3.1 standard is required.
- Only complete submissions will be considered for an award.
- APHL employees and contractors are not eligible for Challenge awards.
- Participants who have received CDC funding for ODH implementation must show evidence of implementing collection of additional ODH data elements, in addition to meeting other Challenge requirements, to be eligible for an award.
- Watch the Challenge Kick-Off Call recording from Thursday, May 4, 2023. (optional) See our FAQs about the Challenge and reach out to eCR-Info@aimsplatform.org with any questions.
- Express Intent: Complete the non-binding Challenge participation interest form by midnight ET on Friday, August 18, 2023.
- Submit materials: Email evidence of completion of challenge criteria to eCRfirstname.lastname@example.org by midnight ET on Friday, November 17, 2023.
Additional Challenge Data
Although these data elements are not required for the Challenge, including them (using the value sets identified in the eICR R3.1 standard and correctly mapped into the R3.1 template) will increase your score based on both the number of these data elements implemented and the percentage of sent documents that include them.
- For each Job (see ODH below):
- Employer name and address
- Work classification
- Supervisory level
- Work schedule
- Start date
- End date
- For Usual Work (see ODH below):
- Start date
- Facility ID – valid Facility National Provider Identifier (NPI), if available
- Laboratory Data
- Preferred Language
- Travel History
- Birth Sex (in addition to Administrative Gender)
- Parent/Guardian Name, Role, and Contact Information
Electronic case reporting (eCR) from EHRs to public health agencies (PHAs) has opened up a new world of electronically enabled public health action while reducing the burden of manual reporting on health care providers and their staff. Providers are legally required to report (Reportable conditions are defined by public health laws in state, tribal, local, and territorial jurisdictions), and can use eCR for the automated, secure, electronic transmission of case data. The data, such as occupation and industry for job(s), can be available for timely public health action.
PHAs use social determinant of health (SDOH) and other data to track disease burden by outcomes or disease rates tied to race, ethnicity, gender, sexual orientation, gender identity, disability status, and work, for example. Public health actions can include identifying clusters of disease, determining the relationships between disease and these factors, and developing and implementing specifically targeted interventions. For example: Silicosis is a severe lung disease which typically has a long latency but can have an acute onset after short-term exposure to very high concentrations of respirable crystalline silica. Case reports with coded work information, as described by Occupational Data for Health (ODH), will help PHAs identify new hazardous types of work and workplaces (e.g., stone countertop manufacturing) and quickly respond with engineering interventions and education to prevent and manage the disease.
All of the data elements in the eICR R3.1 standard are important to public health. For example, coded pregnancy status is critical for understanding the impact of many conditions and to identify and take appropriate actions. For some conditions (e.g., Ebola, Coccidiomycosis) travel history is important. Symptoms are critical for other conditions (e.g., COVID, a polio-like acute flaccid myelitis affecting children) and can’t be acted on if they aren’t coded. Finally, some eICR R3.1 elements add organizational efficiencies unavailable elsewhere. For example, a valid Facility National Provider Identifier (NPI) supports better tracking of Promoting Interoperability letters for health care organization (HCO) partners. Similarly, document custodian and author data allow identification of sender for troubleshooting. Patients’ work information helps public health address health conditions related to work (e.g., silicosis), transmitted in the workplace (e.g., COVID-19), and whose management is affected by work (e.g., diabetes)
Occupational Data for Health (ODH)
ODH is an informatics framework for health IT systems to support individual patient care, population health, and public health.
- The ODH information model describes the ODH data elements, how the elements are related to one another as “topics,” and how the topics are related to a person. HCOs select the topics and data that are important to them.
- Value sets are available for most ODH data elements; for downloadable files, see the ODH Hot Topics tab. Occupation and industry concepts are supported by large value sets that enable keyword searches using common terms.
- A Guide to Collection of Occupational Data for Health (ODH): Tips for Health IT Developers (“The ODH Collection Guide”) provides valuable suggestions for collecting the ODH data elements, particularly occupation and industry values.
- The HL7® Work and Health Functional Profile (WHFP) provides recommendations for functionality to manage ODH data in EHRs.
- ODH interoperability templates enable adding ODH topics into broader implementation guides (HL7 CDA, IHE CDA, FHIR, V2). The Past or Present Job and Usual Work templates are included in the eICR 3.1 standard.
1 Reportable conditions are defined by public health laws in state, tribal, local, and territorial jurisdictions.
2 Challenge submissions must be in accordance with public health law in the respective jurisdiction(s).