Making EHR Data More available for Research and Public Health (MedMorph)
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Making EHR Data More available for Research and Public Health (MedMorph), published by HL7 International - Public Health Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-medmorph/ and changes regularly. See the Directory of published versions

MedMorph Home Page

Official URL: http://hl7.org/fhir/us/medmorph/ImplementationGuide/hl7.fhir.us.medmorph Version: 1.0.0
Active as of 2022-08-01 Computable Name: MakingEHRDataMoreAvailableForResearchAndPublicHealth

Introduction

The Making EHR Data More Available for Research and Public Health (MedMorph) project seeks to advance public health and patient-centered outcomes by using emerging health data and exchange standards, such as Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) and Clinical Quality Language (CQL), to develop and implement an interoperable solution that will enable access to clinical data. The MedMorph project fits within the Centers for Disease Control and Prevention (CDC) strategic imperative of transforming how data are collected, used, and shared through modern Information Technology (IT) capabilities to save lives and improve health. The MedMorph project is funded by the Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Patient-Centered Outcomes Research Trust Fund (PCORTF) and executed by the Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) Public Health Informatics Office (PHIO) to advance research and public health goals.

The project aims to leverage the maturation of standards and requirements for certification of health information technology by the Office of the National Coordinator for Health IT (ONC) that underpin many EHRs. Examples such as FHIR, the ONC 2015 Edition Common Clinical Data Set (CCDS), 2015 Edition Cures Update - United States Core Data for Interoperability (USCDI) Version 1, February 2020 and standardized application programming interfaces (API) for patient services have created a health IT environment that is ripe for developing standards-based scalable and extensible solutions to overcome interoperability challenges.

The MedMorph project will use three fully modeled use cases across three distinct areas that are representative of broader areas of research and public health: Chronic Hepatitis C (Hep C) Surveillance, an infectious disease; Cancer Registry Reporting, a chronic disease; and Health Care Surveys, pertaining to health care utilization and not a specific condition. These three use cases inform the design of a scalable and extensible reference architecture to facilitate data exchange for key patient-centered research questions and public health information system requirements. For more detailed explanation on the reference architecture refer to next paragraph and the Implementation Guide Overview section.

Reference Architecture Overview

The MedMorph Implementation Guide presented here is also known as the MedMorph Reference Architecture (RA) Implementation Guide (IG). Reference Architecture refers to a common framework (e.g., Actors, Systems, FHIR resources, FHIR APIs, FHIR operations, security mechanisms) that will be leveraged by multiple public health and research use cases. The Medmorph RA IG is accompanied by what are called as Content IGs. These content IGs provide specific content profiles that are to be used for a specific use case. Requirements for specific use cases will be driven by the Content IGs where as the requirements for the framework components such as a Backend Services App, Knowledge Artifact Repository, TTP etc are identified in the MedMorph RA. There are example capability statements created for actors whose specific requirements will be identified in the Content IGs.

Examples of Content IGs include Central Cancer Registry Reporting IG and Health Care Survey Reporting IG. The relationship between these IGs are further explained in the IG Relationships section section. An overview of these actors, systems and interactions are explained further in the MedMorph Actors and Systems section and a thumbnail is provided below for reference.

ThumbNailMedMorphActors

IG Sections Overview

The main sections of this IG are:

  • Implementation Guide Overview - provides context for the implementation guide and information that implementers should be familiar with before reading the remainder of the IG.
  • Use Cases and Workflows - describes the business need, actors, and workflows applicable for public health reporting in MedMorph.
  • Public Health Reporting Specification - defines the specific conformance requirements for systems wishing to conform to public health actors specified in the IG.
  • Research Data Partner On-boarding Specification - defines the specific conformance requirements for systems wishing to conform to research data partner onboarding and data mart population.
  • Useful Downloads - provides the ability to download a copy of the entire implementation guide, artifact definitions, or examples.
  • Credits - Lists individuals and organizations that have contributed to the development of the implementation guide.