An official website of the United States government
NHSN FHIR® Implementation Guides and Resources
AT A GLANCE
- Framework and Content Package Implementation Guides: NHSN utilizes both HL7 balloted Framework Implementation Guides (IGs) for standardized reporting and unballoted Content Package IGs for flexible updates, ensuring comprehensive data submission practices.
- Standardization and Flexibility: The Framework IGs establish a common reporting framework using existing standards, while Content Package IGs provide specific profiles and requirements for data submissions tailored to NHSN.
- IG Offerings: NHSN has developed two Framework IGs and three Content Package IGs that support data reporting for surveillance, quality measurement, and situational awareness.
NHSN’s approach to FHIR IGs:
NHSN’s approach to Fast Healthcare Interoperability Resources® Implementation Guides (FHIR IGs) is based on a framework IG that has been balloted and published through HL7 as well as un-balloted Content IGs that are published by NHSN. HL7 IGs provide reliable standards for data submission, while the addition of NHSN content IGs add flexibility for specific use cases.
Figure 1: NHSN approach to FHIR IGs. Image shows the two implementation guides (IGs) that are used for NHSN FHIR measures, broken up into two categories, Surveillance and Quality Measure and Situational Awareness. Both categories have a framework and NHSN content implementation guides. The content IGs are broken up into specific NHSN protocols and metrics that are captured at a monthly or daily frequency.
NHSN’s Framework IGs:
- Have been balloted with HL7
- Standardize data submission for NHSN reporting requirements by establishing a common framework for reporting FHIR data to NHSN
- Leverage existing standards such as FHIR R4, US Core, Data Exchange for Quality Measures (DEQM), QI Core, Quality Measure (QM) IG, Clinical Quality Framework Common FHIR Assets, and Situational Awareness for Novel Epidemic Response (SANER).
- Contain common profiles, value sets, and general requirements for reporting to NHSN.
- Provide exampled measures
- NHSN has two balloted Framework IG’s
- National Healthcare Safety Network (NHSN) Digital Quality Measure (dQM) Reporting Implementation Guide
- Used for surveillance and quality measurement
- Reports patient-level data
- US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide
- Used for reporting Situational Awareness data
- Reports facility-level aggregate data
- National Healthcare Safety Network (NHSN) Digital Quality Measure (dQM) Reporting Implementation Guide
NHSN’s Content IGs:
- Derived from and comply with NHSN’s HL7 balloted Framework IGs
- Remain un-balloted to allow for greater flexibility in updating
- Contain the specific profiles and clinical quality language (CQL) necessary for data submission to NHSN using FHIR
- can be used for FHIR validation of data submission
- NHSN has three Content Package IGs
- CDC NHSN dQM Content Package IG: defines the content requirements for submissions to NHSN via for monthly or daily reporting of patient-level surveillance or quality measurement data. [Note: Release 1.0 of this IG does not inherit from the HL7 dQM Reporting Framework IG as its initial development predated the completion of that Subsequent major versions will inherit from the Framework IG.]
- CDC Bed Capacity IG: Standardizes near-real time automated bed capacity reporting across hospitals and jurisdictions. [Note: This Implementation Guide is currently under development and is not yet publicly available.]
- CDC Hospital Respiratory Data IG: Establishes hospital reporting standards for COVID-19, influenza, RSV, personal protective equipment (PPE) and supply information, and other related data. [Note: This Implementation Guide is currently under development and is not yet publicly available.]
