December 18, 2008

Version 3.2

HITSP Biosurveillance Interoperability Specification

HITSP/IS02    Click here to download the PDF version of this document

Healthcare Information Technology Standards Panel (HITSP) logo

Submitted to:

Healthcare Information Technology Standards Panel

Submitted by:

Population Perspective Technical Committee
(Formerly Population Health Technical Committee)

Document Change History

Version Number

Description of Change

Name of Author

Date Published

1.0

Final Draft

Biosurveillance Technical Committee

August 18, 2006

1.1

Ready for Public Comment

Biosurveillance Technical Committee

September 12, 2006

1.2

Ready for Implementation Testing

Biosurveillance Technical Committee

October 20, 2006

1.3

Review Copy

Population Heath Technical Committee

April 27, 2007

2.0

Released for Implementation

Population Heath Technical Committee

May 11, 2007

2.1

Released for Implementation

Population Heath Technical Committee

December 13, 2007

2.1.1

Review Copy

Population Heath Technical Committee

March 19, 2008

3.0

Released for Implementation

Population Health Technical Committee

March 27, 2008

3.0.1

Review Copy

Population Perspective Technical Committee

August 20, 2008

3.1

Released for Implementation

Population Perspective Technical Committee

August 27, 2008

3.1.1

Review Copy

Population Perspective Technical Committee

December 10, 2008

3.2

Released for Implementation

Population Perspective Technical Committee

December 18, 2008

Table of Contents

1.0 Introduction. 7

1.1 Interoperability Specification Overview. 7

1.2 Interoperability Specification Document Map. 7

1.2.1 List of Constructs. 8

1.3 Copyright Permissions. 9

1.4 Reference Documents. 9

2.0 Interoperability Requirements. 11

2.1 Use Case Synopsis. 11

2.2 Use Case Requirements. 11

2.2.1 Mapping of Use Case Requirements to Interoperability Requirements. 13

2.2.2 Data and Information Requirements Matrix. 19

2.2.3 Identification of Business Actors, and Functional Flow Scenarios. 30

2.2.4 High-Level UML Business Sequence Diagram.. 39

3.0 Design. 45

3.1 Scope of Design. 45

3.1.1 Assumptions. 47

3.1.2 Constraints. 47

3.1.3 Pre-conditions. 51

3.1.4 Post-conditions. 51

3.1.5 Process Triggers. 52

3.2 Detailed Design. 52

3.2.1 Technical Actor Role Descriptions. 56

3.2.2 Sequence Diagram for Process Flow. 58

3.2.3 Mapping of Business Actors to Technical Actors and Constructs with Optionality. 61

3.2.4 Construct Dependencies. 67

3.2.5 Additional Constraints on Required Constructs. 69

4.0 Standards Selection. 74

4.1 List of Standards. 75

4.1.1 Regulatory Guidance. 75

4.1.2 Selected Standards. 75

4.1.3 Informative Reference Standards. 79

4.2 Gaps Where There Are No Standards. 81

4.3 Standard Overlaps. 83

4.4 Resolution Plan Summary. 85

5.0 Technical Implementation. 92

5.1 Conformance. 92

5.1.1 Conformance Criteria. 92

5.1.2 Conformance Scoping, Subsetting and Options. 92

5.1.3 Test Methods. 92

6.0 Appendix. 93

6.1 Description of Standards. 93

6.2 Biosurveillance Glossary. 98

6.3 AHIC Minimum Data Set USHIK Cross-Reference. 99

6.3.1 Cross-Reference Table Key. 99

6.3.2 Base Facility Data Elements. 99

6.3.3 Daily Facility Summary Report Elements. 99

6.3.4 Patient Data Elements. 104

6.3.5 Clinical Data Elements. 105

6.3.6 Laboratory/Microbiology Test Order Elements. 107

6.3.7 Laboratory/Microbiology Result Data. 108

6.3.8 Radiology Result Data. 112

7.0 Change History. 114

7.1 May 11, 2007. 114

7.2 December 5, 2007. 114

7.3 December 13, 2007. 114

7.4 March 19, 2008. 114

7.5 March 27, 2008. 114

7.6 August 20, 2008. 115

7.7 August 27, 2008. 115

7.8 December 10, 2008. 115

7.9 December 18, 2008. 115

Figures and Tables

Figure 1-1 Interoperability Specification Document Map. 8

Figure 2-1 Information Flows for Bed Availability. 38

Figure 2-2 Biosurveillance Business Sequence Diagramfor Message-based Patient-level Surveillance Data Communication . 40

Figure 2-3 Biosurveillance Business Sequence Diagramfor Document-based Patient-level Surveillance Data Sharing 42

Figure 2-4 Biosurveillance Business Sequence Diagramfor Resource Management Data Transfer 44

Figure 3-1 Document Map for Message-based Submissions. 53

Figure 3-2 Document Map for Document-based Submissions. 54

Figure 3-3 Document Map for Resource Utilization Submissions. 55

Figure 3-4 Message-based Patient Data Communication Actor Interaction Diagram.. 59

Figure 3-5 Document-based Patient Data Communication Actor Interaction Diagram.. 60

Figure 3-6 Resource Management Data Transfer Actor Interaction Diagram.. 61

Table 1-1 List of Constructs. 8

Table 1-2 Reference Documents. 9

Table 2-1 Mapping of Use Case Requirements to Interoperability Requirements. 14

Table 2-2 Data Element and Information Requirements. 19

Table 2-3 Data Elements Cross Reference. 19

Table 2-4 Base Facility Data Elements. 20

Table 2-5 Daily Facility Summary Report Elements. 20

Table 2-6 Patient Data Elements. 24

Table 2-7 Clinical Data Elements. 25

Table 2-8 Laboratory and Radiology Test Orders. 27

Table 2-9 Laboratory/Microbiology Result Data Elements. 28

Table 2-10 Radiology Result Data Elements. 29

Table 2-11 Business Actors. 30

Table 3-1 Clinical Example Scenarios. 46

Table 3-2 Assumptions. 47

Table 3-3 Constraints. 47

Table 3-4 Pre-conditions. 51

Table 3-5Post-conditions. 51

Table 3-6 Process Triggers. 52

Table 3-7 Technical Actor Role Descriptions. 56

Table 3-8 Business-Technical Actor Mapping to Transaction and/or Content 62

Table 3-9 Construct Dependencies. 68

Table 3-10 Additional Constraints on Required Constructs. 69

Table 3-11 XDSDocumentEntry Element Constraints. 72

Table 4-1 Regulatory Guidance. 75

Table 4-2 Selected Standards Linked to HITSP Constructs. 75

Table 4-3 Informative Reference Standards. 79

Table 4-4 Use Case Events and Associated Gaps. 81

Table 4-5 Standard Overlaps. 84

Table 4-6 Resolution Plan. 85

Table 6-1 Description of Standards. 93

Table 6-2 Data Elements Cross-Reference. 99

Table 6-3 Base Facility Data Elements. 99

Table 6-4 Daily Facility Summary Report Elements. 99

Table 6-5 Patient Data Elements. 104

Table 6-6 Clinical Data Elements. 105

Table 6-7 Laboratory/Microbiology Test Order Elements. 107

Table 6-8 Laboratory/Microbiology Result Data. 108

Table 6-9 Radiology Result Data. 112