Early Hearing Detection and Intervention and Electronic Health Records Technology

This information is for:

• Program directors of state Early Hearing Detection and Intervention (EHDI) programs,
• Developers of EHDI computer-based information systems, and
• Vendors of electronic health records systems.

EHDI staff and technical experts can use this information to achieve interoperability and thus to improve how data is collected, analyzed, and used.

Interoperability describes the extent to which systems and devices can exchange data, and interpret that shared data. In healthcare, interoperability means the ability of health information systems to work together within and across organizational boundaries to advance effective delivery of healthcare for individuals and communities.

The CDC Early Hearing Detection and Intervention (EHDI) Team have been collaborating with national and international organizations on standards for improved interoperability between clinical electronic health records (EHR) and public health information systems. This joint effort is working to develop, test and adopt the new standards.

The links and downloadable documents below can be used to access content related to each output area.

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  • HHS Web standards

There are four sections below with several Web links; each provides some of the information needed to learn about the recent improvements.

1. Code Sets:

What this is: A “code set” is any set of codes used for encoding data elements, such as tables of terms, medical concepts, medical diagnosis codes, or medical procedure codes.  Code sets developed for EHDI include hearing screening procedures and results, risk factors, and other medical diagnosis and intervention codes related to infant hearing loss.

• Newborn Screening Coding and Terminology Guide
  • Purpose: To provide codes and terminology for newborn hearing screening procedures, results, and risk factors for infant hearing loss. 
  • Standard System(s): LOINC®, SNOMED-CT
  • View/Download

2. Data Interchange Implementation Guides

What this is: Technical guidelines on how to implement interoperability standards to support data exchange among different health information systems, including clinical EHR, healthcare device, and public health tracking and surveillance systems.

• HL7 Version 2.6 Implementation Guide: Early Hearing Detection and Intervention (EHDI) Results:
  • Purpose: To standardize how newborn hearing screening information is transmitted from a point of care device to an interested consumer such as public health
  • Standard System(s): HL7 v2.6
  • View/Download

• IHE Quality, Research and Public Health Technical Framework Supplement: Newborn Admission Notification Information (NANI)
  • Purpose: To describe the content needed to communicate a timely newborn admission notification electronically from a birthing facility to public health. This profile is being implemented for EHDI but could be used for Immunization programs, Newborn Bloodspot Screening, Critical Congenital Heart Disease, or Communicable Disease Reporting.
  • Standard System(s): HL7 v2.3, v3 messaging
  • View/Download (.pdf)

• IHE Quality Research and Public Health Technical Framework Supplement:  Early Hearing Detection and Intervention (EHDI)
  • Purpose: To address information exchange needed in the development of a hearing plan of care for a newborn.  It specifies the content for a Hearing Plan of Care (HPoC) document.  It also specifies the message constraints for a hearing screening device to report a screening interoperability also facilitated by the NANI and QME-EH profiles.
  • Standard System: HL7 CDA R2
  • View/Download (.pdf)

• IHE Quality Research and Public Health Technical Framework Supplement:  Quality Measure Execution – Early hearing (QME-EH)
  • Purpose:  to define the patient-level quality report needed for the Hearing Screening Prior to Hospital Discharge (CMS31, NQF 1354) electronic clinical quality measure (eCQM) defined by the CDC EHDI program; the measure is used to assess the quality of the process of hearing screening for newborns.  (See Section 3 Below)
  • Standard System: HL7 QRDA
  • View/Download (.pdf)

3. Electronic Quality Measure Specifications

What this is: Standards for electronically representing clinical quality measures, which are tools that are defined to help measure and track the quality of health care services provided by professions and hospitals within our health care system.

• Hearing Screening Before Hospital Discharge (NQF1354/CMS31)
  • Purpose: To define electronic clinical quality measure for newborn hearing screening quality reporting, adopted by the CMS EHR “Meaningful-Use” Incentive Program for Hospitals and Critical Access Hospitals
  • Standard System: HL7 HQMF (QDM based)
  • View/Download
    • eMeasure definition (.xml) (.html)
    • Value sets (.xls)

4. EHR System Public Health Functional Profile

What this is: Functional requirements and criteria to support public health-clinical information collection, management and exchanges for specific public health programs (domains). The profile may serve as the reference for certification of EHR systems that include functionality to support Public Health domains.

• HL7 EHR System Public Health Functional Profile
  • Purpose: To define functional requirements and criteria to support public health-clinical information collection, management and exchanges for specific public health programs (domains)
  • Standard System: HL7 EHR-S Functional Model
  • View/Download