Use Case Scenarios Leveraging Public Health’s Experience with Information Standards and Health Improvement

Infectious Disease Scenario for Community Health Info Exchange A three-year old presents for the first time to a pediatric care provider with a one-week history of cough without fever. The coughing occurs in prolonged episodes of several minutes, followed by vomiting on three occasions. Unknown to the pediatric care provider, twelve cases of pertussis (whooping cough) have been reported in the county over the past month. The child’s guardian brought no vaccination record to the visit. (Note: pertussis can be transmitted by respiratory spread (breathing contaminated air). Even previously vaccinated adults with trivial symptoms can be infected and infect others for up to three weeks unless treated. Contemporary public health practice is to routinely vaccinate all children under age 7, isolate known and suspect cases until treated for 5 days; and isolate contacts to known cases until treated for 5 days.)

Questions Infectious Disease Scenario How might a local health information exchange help the pediatric care provider make the right diagnosis? How might a local health information exchange help public health authorities learn about possible new cases of pertussis? How might a local health information exchange enable providers and guardians access to information on past immunizations? What information-sharing/communications modalities already exist that could support better outcomes in such cases? What information-sharing/communications modalities are on the horizon that could support better outcomes in such cases? What obstacles to such information sharing exist, and how could they be addressed?

Chronic Disease Management Scenario for Community Health Info Exchange Healthcare providers in the Technology Valley metropolitan region have completed a health information exchange that assembles, for each participating patient, historical information on diabetes-related laboratory information (e.g., Hemoglobin A1C), prescriptions, and medical and surgical procedures (CPT codes). Local public health departments in Technology Valley offer community nutrition programs, home visiting nursing programs, and community health information through face-to-face groups, public health clinics, printed and electronic media. Patient information is not shared between the HIE and the public health client management information systems. Summary population data from the HIE (which can be displayed geographically and by other demographic characteristics) have not been shared with local public health agencies.

Questions Chronic Disease Management Scenerio How might sharing of population-level data improve diabetes outcomes in Technology Valley? How might sharing of individual-level data improve diabetes outcomes in Technology Valley? What information-sharing/communications modalities exist that could improve diabetes outcomes in this situation? What information-sharing/communications modalities are on the horizon that could improve diabetes outcomes? What obstacles to such information sharing exist, and how could they be addressed?