Addressing Privacy and Security In Nebraska Public Health Information Exchanges Public Health Informatics: Collaboration at the Crossroads

Public Health Privacy / Security Challenges Public Health Vision Public Health Informatics: Collaboration at the Crossroads Addressing Privacy and Security in Nebraska Public Health Information Exchanges Federal Mandate Public Health Privacy / Security Challenges Public Health Vision The Nebraska Perspective Nebraska Initiatives Recommended Policies and Practices

Federal Mandate Goal: Improve population health Strategy: Unify public health surveillance platforms into one interoperable platform Strategy: Streamline quality and health status monitoring Strategy: Accelerate research and dissemination of scientific data and discoveries

Developing a Public Health Vision Know your purpose Understand the past Think positively about the future Expand potential Plan strategically Focus on future

Know your Purpose: To Improve the Public’s Health Traditional Public Health Practice: Systematic, ongoing data collection Analysis Interpretation Dissemination Link to public health practice and research

Understand the past Work in the Present Focus on the Future Program Centric Driven by Funding Non Compatible Systems Non Compatible Data Non Compatible Language FUTURE Person Centric Driven by Funding Systems Compatible Data Compatible Language Compatible

Status of Public Health Systems Began as stove pipe systems evolving into degrees of integration. Generally data is one direction. With new standards the options exist for greater bi-directional communication Generally remain program or population centric Controlled by States Post event Reporting Funding and outbreak driven

Vital Records, Registries, Surveys, Chronic Disease Infectious Diseases EMS Trauma CODES Injury Communicable Diseases Seasonal Influenza STD DATA INTEGRATION AND ANALYSIS TB Pandemic Influenza HIV AIDS Food Borne Diseases Epidemiology Entomology Public Health Veterinarian Grants Management Vital Records, Registries, Surveys, Chronic Disease

of Population Health IT Personal Vision of Population Health IT Person Centric Real Time Data Collection Real Time Data Extraction and Analysis Person Centric Privacy Maintained Direct data Integration – human readable Significant Improvement in Population Health Seamless Integration with Personal Health Care System Knowledge Repository (both practice and legal) Direct data integration indicates that meaning in human language is accessible to all. Does not require a programmer to interpret it. It is not coded and decoded. Reliable data for all purposes.

Public Health Privacy / Security Challenges History Pre-HIPPA Freedoms, Constraints, Failures Present- Information Excess, Access, Overload Technology challenges HIPPA Loss of Border Control - state and federal Tomorrow Our Choice – A Need for a National Public Health Vision

The Nebraska Perspective Nebraska eHealth Council Initiatives: Create and encourage communication among all partners, especially HIEs. Foster adoption of all types of Health Information Exchange Create Information Exchange Backbone Nebraska HISPC Initiatives: Identify and remove barriers caused by laws and regulations Educate and inform citizens and stakeholders

Nebraska Initiatives (related to Privacy and Security) Health Information Security and Privacy Committee (HISPC) HISPC 10 State Collaborative Public Health Data Standards Consortium (PHDSC) Public Health Information Network (PHIN) National Governor’s Association- Center for Best Practices- Privacy Security Task Force Health Information Technology Panel (HITSP)

Recommend Policies and Practices We have changed some regulations, and will change more. HISPC continues to review laws and regulations Invest in systems that meet CCHIT, HITSP and PHIN requirements Invest in systems that do more… Think long range, Think strategically, Think big picture, Practice inclusive integration

Contact Information: David P. Lawton Public Health Informatics Coordinator Nebraska Division of Public Health david.lawton@dhhs.ne.gov (402) 471-0507