Public Health Data Standards Consortium

1 PHDSC / eHealth Initiative Annual Conference May 2005, Washington, D.C. Public Health participation in health information exchanges: Accelerating adoption and widespread use of HIT David A. Ross, Sc.D. Director, Public Health Informatics Institute

2 Public Health Mission u Institute of Medicine – “what we, as a society, do collectively to assure the conditions in which people may be healthy.” u Public health must be a partner to fulfill its mission Mandated to protect and improve the health of all people within a legal jurisdiction Public health informs, coordinates care and resources, and regulates Effective public health requires an understanding of the interdependent nature of its functions with those of the health care system

3 What can public health bring to the party? u Information intensive business Surveillance systems Case management systems Environmental monitoring systems Emergency response and coordination systems u Agent for transforming data into information Analytical methods and epidemiology as core competencies Data warehouse capabilities Preventive service guidelines u Neutral convening authority Governmental entities charged with improving everyone’s health

4 Where public health adds value to HIE u Provider of patient information and direct services Immunization registry data and decision support Laboratory analysis, results reporting and population-based analysis and recommendations Care coordination for children with special healthcare needs u Provider of epidemiologic information to improve diagnostic accuracy and treatment decisions Outbreak alerts Patterns of drug-resistant organisms within a community Trends that spark community collaboration on new health initiatives Inform health payor planning

5 Where public health adds value to HIE u Convenient access to guidelines and recommendations Infection control practices Screening recommendations, etc. u Point of service tools for diagnosis or patient education Guidelines embedded in EHR’s sensitive to local prevalence and service information Screening reminders for local at risk groups Information for patients in need of supportive social or other services – e.g., children with special needs, rehab services, etc. u Automated tools for quality improvement Immunization audits of office practices Newborn screening follow-up (e.g., sickle cell) and care coordination

6 Where public health benefits u Timely disease reporting u Improved case management and care coordination Communicable disease patient management (e.g., TB) Newborn screening follow-up u Improved analysis of patterns of care and gaps in delivery of preventive services u Closer working relationship with health care delivery partners

7 Challenges for public health u Leadership How to counteract the instability of politically appointed leaders? How to balance regulatory roles with community partnership? Can public health play a role in governance? u Financing participation Legislatures direct activity through appropriations – what level of commitment must public health bring to the information exchange? u Business-like data trading partnership Can public entities link systems with reliable performance? Can the heath care provider count on public health data quality and availability?

8 How to accelerate public health participation? u Uniform, sustainable and modern information infrastructure Uniformly definition of public health business processes Base level of nationally adopted information system requirements derived from core business processes u Financial commitment Infrastructure must be supported as a core cost of doing business,not as an annually appropriated activity that competes with other programs u Continuous participation in national standards setting bodies Collaboration to bring clear, defensible positions that argue for specific standards on behalf of the public health enterprise

9 Why requirements are so important for public health to be a member of the HIE u Health information exchanges will depend on viewing each member as a node u Public health needs an integrated information architecture and infrastructure at local and state levels u Public health agencies do not presently hold a common understanding nor articulation of their information system requirements, except for specific application areas (e.g., infectious disease surveillance) u Logical conceptualization of requirements established around a framework of business processes will enable public health to build a sustainable and rational information infrastructure

10 Questions? Dave Ross