Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 10 - Office of the Director › Chapter 33 - Hospital and Ambulatory Surgical Center Data Disclosure › Section 19 CSR 10-33.040 - Electronic Reporting of Patient Abstract Data by Hospitals for Public Health Syndromic Surveillance

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes procedures for secure
				  electronic reporting of patient abstract data for inpatients and outpatients by
				  hospitals to the Department of Health and Senior Services for the purpose of
				  conducting epidemiologic monitoring and studies and publishing information to
				  safeguard the health of the citizens of Missouri as authorized by sections
				  192.020,
				  192.067
				  and
				  192.667,
				  RSMo.
(1) The following
				definitions shall be used in the interpretation of this rule in addition to the
				definitions found in 19 CSR 10-33.010:
(A)
				Batch message file means the transmission of a file containing multiple
				discrete standard electronic messages to the department from the hospital data
				system on a periodic basis less than real time.
(B) Chief complaint means the textual literal
				or ICD-9-CM code or both pertaining to the initial complaint a patient stated
				during an acute care hospital encounter.
(C) Data encryption means the electronic
				obfuscation of data within an electronic message using industry standard
				practices for encryption including, but not limited to: Public Key
				Infrastructure (PKI), digital certificates/signatures, department generated
				symmetric keys, or by secure message transport protocols. Minimum requirements
				will be triple DES 128-bit encryption.
(D) Default standard message means a standard
				electronic message meeting HL7 2.3.1 Admission, Discharge, and Transfer (ADT)
				specifications as identified in Exhibit A, included herein.
(E) Acute care hospital encounter means
				patients seen in the emergency room, urgent care and inpatient admissions of a
				hospital.
(F) Real time message
				means the transmission of discrete standard electronic messages to the
				department as they are generated by the hospital data system.
(G) Secure message transport protocol means a
				method of sending electronic data to the department in a way that prevents
				unauthorized access to the data. Possible methods include: Virtual Private
				Network (VPN), Secure File Transport Protocol (SFTP), secure socket layer
				(HTTPS/SSL), Secure SHell (SSH), encrypted files using TCP/IP, or other secure
				transmission protocol agreed upon by the hospital and the department.
(H) Standard electronic message means a real
				time message or batch message file meeting national or international standards
				for the electronic interchange of data. Standards include, but are not limited
				to, Health Level 7 (HL7), Extensible Mark-up Language (XML), Electronic
				Business XML (ebXML), Electronic Data Interchange (EDI), and other standards as
				they become available.
(I) Hospital
				means a hospital as defined in section
				197.020, RSMo. For
				the purposes of this rule only, hospital shall not include a hospital in a
				rural area as defined in section
				191.500, RSMo; a
				hospital designated by the Health Resources Services Administration as a small
				rural hospital; a hospital licensed as a psychiatric or a rehabilitative
				hospital; or a hospital without an emergency room. Following the completion of
				implementation of plans submitted to and approved by the department pursuant to
				section (4), the department may review the need to expand this definition to
				include hospitals in a rural area as defined in section
				191.500, RSMo or
				hospitals designated by the Health Resources Services Administration as a small
				rural hospital.