This page is part of the Vital Records Birth and Fetal Death Reporting (v1.0.0: STU 1 on FHIR R4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Overview

Birth and fetal death reporting includes the transmission of data from health care providers to jurisdictional Vital Records Offices and national health statistics agencies. Data associated with the mother of the baby or fetus may be communicated independently from that associated directly with the labor and delivery encounter at the responsible healthcare facility. Note that for the purposes of this guide, “mother” always refers to the woman who delivered the infant. In cases of surrogacy or gestational carrier, the information reported should be for the surrogate or the gestational carrier, that is, the woman who delivered the infant. Also, the national statistics agency referred to in this guide is the National Center for Health Statistics - CDC (NCHS).

This implementation guide (IG) defines a series of FHIR profiles on the Composition resource to represent electronic birth and fetal death reporting (BFDR) reports. It includes the content of medical/health information on live births and fetal deaths for select state and federal birth and fetal death reporting, as indicated in the 2003 Revision of the U.S. Standard Certificate of Live Birth and the U.S. Standard Report of Fetal Death. Additionally, it includes the content that is exchanged between electronic health record (EHR) systems, jurisdictions, and the Centers for Disease Control and Prevention/ National Center for Health Statistics (CDC/NCHS).

Relationship to Other Standards

This BFDR implementation guide standard complements other vital records standards to support the expansion of information flow to and from the national statistics agency. It is informed by:

• HL7, Version 2.6 Implementation Guide: Vital Records Birth and Fetal Death Reporting, Release 1,STU Release 2.1 - US Realm (April 2020)
• HL7, CDA® R2 Implementation Guide: Birth and Fetal Death Reporting, Release 1, STU Release 2 - US Realm (June 2019)
• HL7, Vital Records Mortality and Morbidity Reporting (VRDR) FHIR Implementation Guide 1.0.0, STU 1 (October 2020)
• IHE , Quality, Research and Public Health Technical Framework Supplement - Birth and Fetal Death Reporting-Enhanced (BFDR-E) (September 2018)
• ONC, United States Core Data for Interoperability (USCDI) (April 2020)

Dependencies

This implementation guide re-uses profiles from the following guides:

• Vital Records Common Profiles Library
• US Core Implementation Guide

Audience

This guide is for analysts and developers who require guidance on the use of the HL7 FHIR for providing birth and fetal death reporting information. The implementation guide is informative to health care provider organizations, jurisdictional Vital Records Offices, CDC/NCHS, health information exchange organizations, and other vital records fetal death reporting stakeholders.

Background

This FHIR implementation guide builds on previous electronic data standards for transmitting vital records of death, birth, and fetal death. The goal has been to transmit reliable and relevant clinical information to jurisdictional Vital Records Offices and to transfer information from Vital Records Offices to the national statistics agency.

Electronic vital records work started with the HL7 Vital Records Domain Analysis Model (VR DAM), published as an Informative Specification in 2011. The VR DAM was updated in 2017 with the HL7 Cross-Paradigm Domain Analysis Model: Vital Records, Release 2, in 2018, with Release 3, and in November 2020 as Release 4.

This FHIR implementation guide uses the US Core profiles. Where this FHIR implementation guide is unable to use a US Core profile, we have followed the Cross Group Projects WG’s variance request process, and have provided the US Realm Steering Committee an approved rationale for deviation in the implementation guide.

How to Read This Guide

This Guide is divided into several pages which are listed at the top of each page in the menu bar.

• Home: The home page provides the introduction and background for HL7 FHIR® Vital Records Common Profiles Library.
• Use Cases: This page details the use cases supported by this guide.
• Implementer Guidance: This page details the worksheet Questionnaire format and the relationship to the IHE specification.
• Terminology: This page provides a listing of the value sets used in this guide.
• Downloads: This page provides links to downloadable artifacts.
• Artifact Index: This page provides a list of the FHIR artifacts (profiles, examples, and value sets) defined as part of this guide.
• Appendices: This pages provides examples of live birth and fetal death reports and worksheets.

Author

HL7 International - Public Health

Other Information

This is the first FHIR BFDR standard.

This guide is compliant with FHIR Release 4.

For Clinical Safety Information please refer to the FHIR Implementer’s Safety Checklist.

Disclaimer: All proprietary documents, guides, guidance, standards, codes, and values contained herein remain the property of their respective Standards Developing Organization (SDO). HL7 does not make any claim to ownership herein.

Authors

Name	Email/URL
HL7 International - Public Health	http://www.hl7.org/Special/committees/pher