Introduction

The Making EHR Data More Available for Research and Public Health (MedMorph) project seeks to advance public health and patient-centered outcomes by using emerging health data and exchange standards, such as Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) and Clinical Quality Language (CQL), to develop and implement an interoperable solution that will enable access to clinical data. The MedMorph project fits within the Centers for Disease Control and Prevention (CDC) strategic imperative of transforming how data are collected, used, and shared through modern Information Technology (IT) capabilities to save lives and improve health. The MedMorph project is funded by the Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Patient-Centered Outcomes Research Trust Fund (PCORTF) and executed by the Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) Public Health Informatics Office (PHIO) to advance research and public health goals.

The project aims to leverage the maturation of standards and requirements for certification of health information technology by the Office of the National Coordinator for Health IT (ONC) that underpin many EHRs. Examples such as FHIR, the ONC 2015 Edition Common Clinical Data Set (CCDS), 2015 Edition Cures Update - United States Core Data for Interoperability (USCDI) Version 1, February 2020 and standardized application programming interfaces (API) for patient services have created a health IT environment that is ripe for developing standards-based scalable and extensible solutions to overcome interoperability challenges.

The MedMorph project will create fully modeled use cases across three distinct areas that are representative of broader areas of research and public health: Chronic Hepatitis C (Hep C) Surveillance, an infectious disease; Cancer Registry Reporting, a chronic disease; and Health Care Surveys, pertaining to health care utilization and not a specific condition. These modeled use cases inform the design of a scalable and extensible reference architecture to facilitate data exchange for key patient-centered research questions and public health information system requirements. For more detailed explanation on the reference architecture refer to Implementation Guide Overview.

Technical Overview

The main sections of this IG are:

• Implementation Guide Overview - provides context for the implementation guide and information that implementers should be familiar with before reading the remainder of the IG.
• Public Health Use Cases - describes the business need, actors, and workflows applicable for public health reporting in MedMorph.
• Research Use Cases - describes the business need, actors, and workflows applicable for researcher data access in MedMorph.
• Public Health Reporting Specification - defines the specific conformance requirements for systems wishing to conform to public health actors specified in the IG.
• Research Data Partner Onboarding Specification - defines the specific conformance requirements for systems wishing to conform to research data partner onboarding and data mart population.
• Research Data Query Specification - defines the specific conformance requirements for systems wishing to conform to research data query actors specified in the IG.
• Useful Downloads - provides the ability to download a copy of the entire implementation guide, artifact definitions, or examples.
• Credits - Lists individuals and organizations that have contributed to the development of the implementation guide.