Reporting Antimicrobial Use and Resistance Information to Public Health Agencies

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	HL7® Implementation Guide for CDA® Release 2 – Level 3: Healthcare Associated Infection Reports, Release 1, U.S. Realm.	Final	Production		Yes	Free	Yes
Implementation Specification	HL7 CDA R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 - US Realm	Balloted Draft	Production	Feedback Requested	Yes	Free	Yes

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
This is a national reporting system to CDC. Stakeholders should refer to the National Healthcare Safety Network (NHSN) at: https://www.cdc.gov/nhsn/cdaportal/meaningfuluse.html for information on participation. Release 1 of the Healthcare Associated Infections IG is normative and used in ONC certification. While there are more current releases of the Healthcare Associated Infection Reports IG, they are not valid for AU or AR submissions to NHSN. These newer releases can be found at the same link as Release 1. The HL7 CDA R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ONC’s Standards Version Advancement Process (SVAP).	Secure Communication – Create a secure channel for client-to-server and server-to-server communication. Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery. Authentication Enforcer – Centralized authentication processes. Authorization Enforcer – Specifies access control policies. Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos). Assertion Builder – Define processing logic for identity, authorization and attribute statements. User Role – Identifies the role asserted by the individual initiating the transaction. Purpose of Use – Identifies the purpose for the transaction.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

This is a national reporting system to CDC. Stakeholders should refer to the National Healthcare Safety Network (NHSN) at: https://www.cdc.gov/nhsn/cdaportal/meaningfuluse.html for information on participation.
Release 1 of the Healthcare Associated Infections IG is normative and used in ONC certification. While there are more current releases of the Healthcare Associated Infection Reports IG, they are not valid for AU or AR submissions to NHSN. These newer releases can be found at the same link as Release 1.
The HL7 CDA R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ONC’s Standards Version Advancement Process (SVAP).

Secure Communication – Create a secure channel for client-to-server and server-to-server communication.
Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – Centralized authentication processes.
Authorization Enforcer – Specifies access control policies.
Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos).
Assertion Builder – Define processing logic for identity, authorization and attribute statements.
User Role – Identifies the role asserted by the individual initiating the transaction.
Purpose of Use – Identifies the purpose for the transaction.

Comment

Submitted by gdixon on 2018-09-18

AUR Comments

According to this page, the emerging IG is DSTU Release 2.1. However when you follow the link, HL7 site indicates the latest version as Release 2 (Nov 2015). Version numbers do not match from HealthIT and HL7 sites.

Following are comments on HAI IG Release 2 (downloaded from HL7 site):

Volume 2, Page 141, Section 2.1.20, “5. SHALL contain at least one [1..*] entry (CONF:1181-23046) such that it”

Comment: NHSN protocol limits exact number of entries to be reported in order to be submitted to CDC successful. This needs a clarification with referencing back to NHS AUR module protocol to know the exact number to be included.