Data Integration Building Blocks (DIBBs)

Difference in Docs

Reduce eCR volume by focusing on useful updates

Difference in Docs determines whether an updated eCR contains useful changes. By withholding records with redundant updates, Difference in Docs reduces the volume of reports sent to jurisdictions, allowing case investigators to focus on meaningful updates rather than sorting through repetitive files. Difference in Docs is hosted on the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS).

Product features:

• Automated version comparison
  Performs an automated comparison between the current eCR and the last version sent to the jurisdiction to detect new, updated, or deleted entries
• Actionable change detection
  Analyzes differences to distinguish between reports containing essential clinical updates and reports containing only routine administrative modifications
• Smart routing
  Determines whether to deliver the eCR to the jurisdiction based on the presence of actionable changes, effectively suppressing "noise" from the data stream
• Highlighted changes
  Delivers an updated eCR showing exactly what changed and where, reducing the manual effort required to find valuable case data

eCR Refiner

Tune eCR size and content

The eCR Refiner is a data processing tool that retains only the most pertinent information from eCR files. An optional and configurable piece of each jurisdiction's eCR pipeline, it is hosted on the AIMs platform.

Product features:

• More relevant and actionable eCR data
  Users refine eCRs with configurable filters, so they receive only the information they need for reportable conditions
• Improved privacy and legal protection
  Jurisdictions can help minimize exposure to legal and compliance risks by removing sensitive fields from files
• Lower processing and storage costs
  Smaller, streamlined files are easier and cheaper to process and store
• Improved usability of eCR in case identification and reporting
  With reduced file size, files will be better suited for automated case identification and reporting
• Easier adoption through centralized AIMS hosting
  Access to new eCR refinement capabilities through a familiar and trusted platform

eCR Viewer

Improve eCR access and readability for public health jurisdictions

The eCR Viewer makes it easier for public health staff to find relevant information in eCR documents. It combines both the eCR and reportability response (RR) records into a single view and highlights relevant lab or clinical information for conditions present in the eCR.

Two versions are available:

• Integrated eCR Viewer
• Standalone eCR Library

With the Integrated eCR Viewer, public health staff access the eCR Viewer directly within their surveillance system. Direct integration is currently supported by the National Electronic Disease Surveillance System Base System (NBS) and EpiTrax. Once installed, the eCR Viewer is activated from the existing eCR document view in NBS. This will open a separate window with the eCR Viewer.

The Standalone eCR Library enables users to view eCR documents outside of their jurisdiction's surveillance system. In addition to the core eCR Viewer, this tool provides an eCR Library homepage, allowing users to filter and sort eCR documents. Users log into the standalone tool separately from their surveillance system.

Product features:

• Summarizes data highlights at the top of the page
  Users can quickly find the information they need
• Combines information from eCR and RR
  Epidemiologists reviewing the eCR can understand why it was sent to their jurisdiction
• Keeps data formats consistent
  eCR formatting will be consistent regardless of which electronic health record system generated the eCR
• Generates a database of parsed eCR data
  Epidemiologists can easily query and use data
• Offers flexible hosting within jurisdictions
  All cloud providers are supported

Query Connector

Get data from health care organizations (HCOs) with a single search

The Query Connector allows public health staff to query a wide network of HCOs for data relevant to a condition. It gives staff access to more complete and timely data without the need for direct connection to an HCO. It does this by leveraging Fast Healthcare Interoperability Resources® (FHIR) endpoints available through data use agreements, like the Data Use and Reciprocal Support Agreement (DURSA) and the Trusted Exchange Framework and Common Agreement (TEFCA). HL7® and FHIR® are the registered trademarks of Health Level Seven International and use of these trademarks does not constitute an endorsement by HL7.

There are two ways to use the Query Connector:

• Web-based portal
• Application programming interface (API)

The portal allows users to create custom queries for specific use cases and conduct individual data searches by inputting patient demographics. The API offers an automated way to connect with a jurisdiction's own data system and works from anywhere in a jurisdiction's workflow (most commonly via Rhapsody).

Product features:

• Access to complete, timely patient data
  Provides better data to track disease outbreaks and manage public health responses more effectively
• Robust security features
  Doesn't store data (thereby avoiding security issues), provides comprehensive access management, lets jurisdictions incorporate an existing Identity Provider, and allows user activity, aiding with compliance
• Multifaceted customization
  Add commonly used codes to a code library, create a custom repository of queries, and assign queries to individuals or entire teams
• Easy integration
  Reduces storage burden on the system and integrates easily into existing workflows by operating outside of a jurisdiction's case surveillance system both as an API and as a web-based portal.

Text to Code

Automatically standardize unstructured data in eCRs

Text to Code (TTC) identifies unstructured fields in eCRs and converts them into standardized codes from national value sets (i.e., LOINC and SNOMED), while preserving the original information. By standardizing eCR lab fields, TTC enables the Reportable Conditions Knowledge Management System (RCKMS) to determine reportability more accurately and ensures more complete, consistent routing of eCRs to jurisdictions—ultimately minimizing manual review and supporting more accurate reporting.

TTC is hosted on the AIMS platform upstream of RCKMS.

Product features:

• Standardized lab codes for key eCR data elements
  Identifies and converts non-standard or unstructured eCR fields into standardized codes from the national value sets, LOINC and SNOMED
• Improved reportability evaluation
  Standardizes eCR lab fields before RCKMS processing, ensuring more accurate evaluations for reportability
• Reduced manual burden for jurisdictions
  Standardization means less time interpreting local codes or unstructured text in eCRs
• Preserves original information for transparency
  Both original values and standardized codes appear in the transformed fields
• Integrated within the AIMS ecosystem
  Standardized codes are applied automatically because TTC is hosted on the AIMS platform upstream of RCKMS
• Built to support additional eCR data elements over time
  While targeted to specific, high impact eCR lab fields, it will also expand to additional eCR fields that would benefit from standardization