National Center for Health Statistics NCHS Vital Records

National Center for Health Statistics (NCHS) Vital Records Birth and Fetal Death Reporting FHIR Implementation Guide July 13, 2020 © 2019 Lantana Consulting Group / www. lantanagroup. com

Agenda • Common Vital Records IG • Quick update on progress/discussions • • • Overview of IG IG Setup Guidance Profile Creation Newborn Name Observation subject/focus Congenital Anomalies of the Newborn • FHIR IG: https: //trifoliafhir. lantanagroup. com/igs/lantana_hapi_r 4/hl 7 -fhir-usbfdr/index. html FHIR CI Build (the above link is always the most up-to-date): https: //build. fhir. org/ig/HL 7/fhir-bfdr/index. html Connectathon page: https: //confluence. hl 7. org/display/FHIR/202009+Birth+and+Fetal+Death+Reporting+DRAFT • •

Common Vital Records IG • All indications at this time are that we will move forward with the “common” vital records IG • Shouldn’t really affect implementation 3

Overview of IG • Most up-to-date version will always be: • • Updated regularly but not as often: • 4 FHIR IG: https: //trifolia-fhir. lantanagroup. com/igs/lantana_hapi_r 4/hl 7 -fhir-usbfdr/index. html FHIR CI Build: https: //build. fhir. org/ig/HL 7/fhir-bfdr/index. html

IG Setup Guidance • • • Grouping on artifacts page useful? Suggestions for easy navigation welcome Mappings useful? • • • 5 Have included Birth/Death Certificates mappings Mother’s Worksheet? Edit specifications?

Profile Creation • 6 Have created 80 -85% of the profiles needed for the Birth Certificate (not including anything that is a “common” profile)

Newborn Name • Trying to use US Core profiles where possible • us-core-patient requires a name: - Patient. name. given or Patient. name. family or both SHALL be present - For a newborn need to allow for “Name not yet chosen” - Unfortunately no option for a null. Flavor like in CDA (though could use data-absent-reason extension = temp-unknown if we didn’t use us-core-patient) State SME feedback: - Is it reasonable to assume that the last name will be known even if the baby name has not yet been chosen? - Or do we need to allow for cases where there is no name at all? - “Baby” - De-dupe issues - MRN will be included, DOB - Look into data-absent-reason extension on Patient. name. given 7

Observation subject/focus • Several Observation profiles are seemingly about the mother, but because the record is about the baby, the guidance is: - Observation. subject = baby - Observation. focus = mother (related person – not patient) • E. g: - Observation – Date of First Prenatal Care Visit Observation – Mother Received WIC Food Observation – Cigarette Smoking Before and During Pregnancy Etc. • Feedback - Is this going to cause issues? - Look into Family History - Look into IHE - Ask question on Zulip 8

Congenital Anomalies of the Newborn - https: //trifolia-fhir. lantanagroup. com/igs/lantana_hapi_r 4/hl 7 -fhir-us-bfdr/Structure. Definition. Condition-congenital-anomaly-of-newborn. html 9