Configuration and Environment
CDC Reporting
• Oregon’s State Public Health Laboratory (OSPHL) delivers multiple files to the same directory communication point.
• Standard HL7 2.3.1 ORU messages for reportable conditions are ingested by an ELR repository.
• PHLIP files are deidentified, translated, and delivered to an outbound PHINMS client for CDC.
• LIMSi files are simply routed to PHINMS server for delivery to CDC.
• An Excel file of all test performed from the previous day is parsed and inserted into a database that state epidemiologists can query.
MU
• Immunization Program uses Rhapsody for Meaningful Use test message validation – they poll a database that is populated from web entry, validate the message, and return validation results to the database for display on the web.
ELR (Orpheus)
• Data are retrieved from an SFTP server via Windows script and deliver to a single directory communication point to process, and an inbound PHINMS database is polled for new data.
• Various versions of HL7 (2.3.1, 2.4, 2.5.1) ORU messages are mapped to 2.5.1, and then inserted into an ELR repository (part of the Orpheus suite) via Java Database Connectivity (JDBC) for processing by local and state epidemiologists.
Syndromic Surveillance (ESSENCE)
• HL7 2.5.1 ADT messages for every emergency department visit in Oregon in the past 24 hours are retrieved from an SFTP server via Windows script and deliver to a directory communication point to process. These data are transformed to fit the standard, but are then denormalized and inserted into ESSENCE.
• A nightly query is sent to the National Poison Data Center for all Oregon calls in the previous 24 hours. These results are then parsed and inserted into ESSENCE.
• And a nightly export from Orpheus is delivered to a directory communication point and inserted into ESSENCE.
HIE
• Poll a table in Orpheus via JDBC that is populated with a fully formed HL7 QBP (immunization history query message) when users make a request. This message is then sent to their immunization registry (ALERT-IIS) via SOAP web- service; when the response is received, it is inserted back into the database (which then processes for the end user).
EHDI
• Their Early Hearing Detection and Intervention program receives HL7 2.7 ORU messages which are transformed into a CSV which can then be imported into their database.
Future Work
• Connecting Rhapsody to the Prescription Drug Monitoring Program (PDMP) database and the statewide HIE (the noun) so providers can query PDMP from their EHRs.
• Connecting the state Public Health Meaningful Use Registration System (PH-MURS) to each of the MU Program onboarding and contact management systems.
