CDC uses new technical approach to enable hospital reporting of healthcare-associated infections

The Centers for Disease Control and Prevention (CDC), with timely assistance from the Association for Professionals in Infection Control and Epidemiology (APIC), is developing a standards-based solution for transmission of healthcare-associated infection (HAI) data from existing commercial software systems to the agency's National Healthcare Safety Network (NHSN).

The vendor-neutral solution enables hospitals to provide data already collected using a commercial system to the federally-funded HAI surveillance network. APIC helped launch CDC's work with vendors by hosting project planning meetings in conjunction with the APIC Annual Conferences in 2006 and 2007.

CDC's pilot project of the new solution in July and August, 2007 was the first field test of the Health Level Seven Clinical Document Architecture Release 2 (HL7 CDA R2) for public health reporting purposes. Once additional testing and development work is completed, CDC plans to integrate the CDA R2 solution for HAI reporting into its production operations of NHSN. "This new use of data standards will make it possible for hospitals to report crucial data to CDC using information technology systems in which they have already invested," said Denise Cardo, M.D., Director of CDC's Division of Healthcare Quality Promotion.

In the pilot project, CDA R2 versions of NHSN's bloodstream infection records were used by participating hospitals as the standard format for transmitting infections data and denominator data needed to calculate infection rates to CDC. Each hospital worked with a software system vendor to report infections and denominator data in accordance with CDA R2 specifications and CDC reporting requirements.

CDC is working with Alschuler Associates, a consulting firm with expertise in HL7 CDA, and a group of commercial HAI surveillance system software vendors, to develop CDA R2 implementation guidance for HAI reporting to NHSN. The six vendors that participated in the pilot project are Cardinal Health MedMinedTM Services, EpiQuest, ICPA, Premier Inc., TheraDoc, and Vecna.

HL7 is moving toward adoption of the implementation guidance for CDA R2 for NHSN HAI Records, developed by CDC and Alschuler Associates, as a Draft Standard for Trial Use. An initial release of the implementation guidance was on the September 2007 HL7 ballot. An updated version of the guidance is included in the January 2008 HL7 ballot.