# Presentation: 949665

## Colorado’s Maternal and Child Health Information System

**American Health Information Community**
- Population Health and Clinical Care Connections Workgroup Meeting
- April 6, 2008
- Chris Wells, PhDc, MS
- Colorado Department of Public Health and Environment

## CSHCN Data Integration System 

- CSHCN – Children with Special Health Care Needs
- CSHCN Data Integration System (IDS)
- CHIRP – Clinical Health Information Records of Patients
- NEST – Needs, Evaluation, Screening and Tracking

## Brief History

- EHDI (Early Hearing Detection and Intervention) grant (October 2000)
- Original 5 year cooperative agreement with CDC
- 3 additional EHDI RFPs (2006-2008)
- CHIRP stand-alone applications completed 2005
- NEST architecture completed July 2006
- CHIRP and NEST applications fully integrated November 2006

## IDS CHIRP

- CHIRP
- Program/Agency specific
- Customized to track program/agency caseload
-  Standard/Customized reports
-  Standard user manual

## IDS CHIRP

- CHIRP Applications
- Newborn Hearing Screening
- Newborn Hearing Follow-up Coordinator
- State Audiologist
- Health Care Program for Children with Special Needs (HCP)
- State HCP staff
- 14 HCP Regional Offices
- County Nursing Offices

## IDS CHIRP

- CHIRP Applications continued
- Traumatic Brain Injury (TBI)
- State HCP Staff for TBI Administration
- Denver Options Staff for TBI Administration
- Newborn Metabolic Screening
- Newborn Metabolic Screening Follow-up Coordinator
- Hemoglobinopathy Screening
- Hemoglobinopathy Follow-up Coordinator

## IDS CHIRP

- CHIRP Applications continued
- Sickle Cell Screening
- The Hemoglobinopathy Follow-up Coordinator
- Sickle Cell Clinic staff at The Children’s Hospital (TCH)
- Inherited Metabolic Disease (IMD) Screening
- IMD staff at The Children’s Hospital (TCH)

## IDS NEST

- NEST
-  Centralized database
-  Assigns unique identifier to each individual
-  Allows CHIRP applications to communicate
-  Shares data based on business rules
-  Built using Microsoft BizTalk Server

**Notes:**
The BizTalk Server will provide three main benefits:
Integration of enterprise applications. Data and transformation services and the application integration features in BizTalk Server can provide businesses with the tools they need to achieve a unified view. BizTalk Server enables businesses to integrate applications through five key processes: document transport and routing, data transformation, application integration, process automation, and scalability and manageability services. 
Automation of business processes. BizTalk Orchestration Designer and BizTalk Orchestration Engine provide organizations with business process automation, enabling their businesses to run predictably. 
Development of operational excellence. BizTalk Server uses technology for automating the integration of business partners over the Internet. 

## IDS NEST

- NEST incorporates data from:
-  CDPHE Vital Records Electronic Birth Certificate (EBC)
- Used by the NBH follow-up coordinator to identify newborn hearing cases, as well as those newborns who missed the screening
- Notify agencies of new information on known individuals
- Daily extract

## IDS NEST

- NEST incorporates data from:
- State Laboratory and Research Department Newborn Metabolic Screening Results
- Used by the NBS follow-up coordinator to follow those children with positive or missing screens
-  Used by the Hemoglobinopathy, Sickle Cell and Inherited Metabolic Disease specialty clinics
- Provide confirmatory diagnostic tests and early intervention efforts
- Daily extract

## IDS NEST

- NEST incorporates data from:
- Colorado Responds to Children with Special Needs (CRCSN)—CO birth defects registry
- Used by CRCSN to send electronic notifications to HCP for possible contact and intervention
- Used by HCP Regional offices and Public Health Nurses for care coordination purposes
- Notifications sent 1 time per month (350/month)

## The Big Picture

- <date/time>

## Advantages to Integrating Data

- Eliminates illegibility and reduces error
- Facilitates data collection and analysis for quality improvement
- Reduces redundancy by eliminating double entry
- Automates and improves communications
-  Automatic generation of letters

## Barriers to Integrating Data

- Lack of standardization for data elements
- Sustained resources including personnel
- Different access rules for different data
- Varying consent and confidentiality provisions
- Other statutory and regulatory restrictions
- Resistance to change
- Communication barriers between interested parties

## Questions?

- Chris Wells, PhDc, MSDirector, Public Health Informatics Unit
- Office:  303-692-2239
- _[chris](mailto:chris.wells@state.co.us)__[.wells@state.co.us](mailto:chris.wells@state.co.us)_