1. Public Health IT
Unit 3: Interoperability Standards in Public Health IT
Welcome to Public Health IT, Unit 3. This unit discusses interoperability standards in public health IT.
Lecture b – Meaningful Use and MIPS Requirements for Public Health
This material (Comp13_Unit3b) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC This material was updated by Columbia University under Award Number 90WT0004.
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2. Interoperability Standards in Public Health IT Learning Objectives
Objective 1: Explain and describe the Meaningful Use and MIPS Advancing Care Public Health Objective
Objective 2: Describe the Public Health Engagement process required for Meaningful Use compliance
Objective 3: Know the ONC Certified Capabilities of EHRs that support public health capabilities
Objective 4: List and discuss the public health IT standards used for Meaningful Use and MIPS Advancing Care public health objectives or referred to in the ONC Standards Advisory
The learning objectives for the interoperability standards in public health IT unit are: 1) Explain and describe the Meaningful Use and MIPS Advancing Care Public Health Objective, 2) Describe the Public Health Engagement process required for Meaningful Use compliance, 3) Know the ONC Certified Capabilities of EHRs that support public health capabilities, and 4) List and discuss the public health IT standards used for Meaningful Use and MIPS Advancing Care public health objectives or referred to in the ONC Standards Advisory. This lecture describes the meaningful use and MIPS requirements for public health reporting.

3. Public health and clinical data registry reporting for Meaningful Use
Meaningful Use requires that eligible hospitals and eligible providers engage with public health authorities to implement data submission interfaces that use certified health IT
Required for all MU stages but this lecture focuses on Modified Stage 2 and Stage 3 since they are most relevant now
The EHR Incentive Program also known as Meaningful Use requires that eligible hospitals and eligible providers engage with public health authorities to implement data submission interfaces that use certified health IT. Public health reporting objectives have been part of the Meaningful Use program since Stage 1. However, this unit focuses on latest stages - Modified Stage 2 and Stage 3 - since they are most relevant now.
Health IT Workforce Curriculum Version 4.0

4. MIPS is a program for paying Medicare Part B doctors
Public health and clinical data registry reporting for the Merit-Based Incentive Payment System (MIPS)
MIPS is a program for paying Medicare Part B doctors
25% of payment is based on the MU objectives (renamed “Advancing Care” for MIPS)
The MU public health objective and measures are included in Advancing Care
Public Health and Clinical Data Registry Reporting is also included in the Merit-Based Incentive Payment System (MIPS). MIPS is a program for paying Medicare Part B doctors starting in percent of payment is based on the MU objectives (renamed “Advancing Care” for MIPS). The MU public health objectives are included in the Advancing Care part of MIPS.
Health IT Workforce Curriculum Version 4.0

5. Meaningful Use public health reporting for eligible hospitals, Modified Stage 2
Must be in active engagement with a public health authority to submit data for three of the following:
Measure 1 – Immunization Registry Reporting
Measure 2 – Syndromic Surveillance Reporting
Measure 3 – Specialized Registry Reporting
Measure 4 – Electronic Reportable Lab Results Reporting
For 2016 and 2017, eligible hospitals attesting to Meaningful Use must meet the Modified Stage 2 objective for Public Health. There are four measures and the eligible hospital must meet three of them. The measures are Measure 1—Immunization Registry Reporting, Measure 2—Syndromic Surveillance Reporting, Measure 3—Specialized Registry Reporting, and Measure 4 – Electronic Reportable Lab Results Reporting. They could meet the Specialized Registry Reporting one more than once with different kinds of registries. Notice that Modified Stage 2 asks for specialized registry reporting and does not distinguish between public health affiliated registries and ones not affiliated with a public health authority.
Health IT Workforce Curriculum Version 4.0

6. Meaningful Use public health reporting for eligible providers, Modified Stage 2
Must be in active engagement with a public health authority to submit data for two of the following:
Measure 1 – Immunization Registry Reporting
Measure 2 – Syndromic Surveillance Reporting
Measure 3 – Specialized Registry Reporting
Meaningful Use Public Health Reporting for eligible providers, Modified Stage 2. Must be in active engagement with a public health authority to submit data for two or more of the following Measures - Measure 1—Immunization Registry Reporting, Measure 2—Syndromic Surveillance Reporting, and Measure 3—Specialized Registry Reporting. The eligible provider can submit to more than one kind of Specialized Registry.
Health IT Workforce Curriculum Version 4.0

7. MIPS Advancing Care (according to proposed rule)
Must be in active engagement with a public health authority to submit data:
Measure 1 – Immunization Registry Reporting
Measure 2 – Syndromic Surveillance Reporting
Measure 3 – Electronic Case Reporting
Measure 4 – Public Health Registry Reporting
Measure 5 – Clinical Data Registry Reporting
Must meet Measure 1 for the base score and can earn one additional point for each additional measure met
According to the proposed rule for MIPS (pronounced MIPS rhymes with tips) Advancing Care, the eligible clinician must be in active engagement with a public health authority to submit data for the following: Measure 1—Immunization Registry Reporting, Measure 2—Syndromic Surveillance Reporting, Measure 3—Electronic Case Reporting, Measure 4- Public Health Registry Reporting, and Measure 5 – Clinical Data Registry Reporting. They must meet Measure 1 for the base score and then can earn one additional point for each additional measure met.
Health IT Workforce Curriculum Version 4.0

8. EH MU Stage 3
Must be in active engagement with a public health authority to submit data for four of the following:
Measure 1 – Immunization Registry Reporting
Measure 2 – Syndromic Surveillance Reporting
Measure 3 – Electronic Case Reporting
Measure 4 – Public Health Registry Reporting
Measure 5 – Clinical Data Registry Reporting
Measure 6 – Reportable Lab Results Reporting
Note that the 2017 OPPS rule may reduce this requirement to three out of six
The Meaningful Use Stage 3 Public Health Objective requires that eligible hospitals be in active engagement with a public health authority to submit data for three of the following: Measure 1 – Immunization Registry Reporting, Measure 2 – Syndromic Surveillance Reporting, Measure 3 – Electronic Case Reporting, Measure 4 – Public Health Registry Reporting, Measure 5 – Clinical Data Registry Reporting and Measure 6 – Reportable Lab Results Reporting. Note that the 2017 Outpatient Prospective Payment System or O-P-P-S rule may reduce this requirement to three out of six. The hospital could choose to report to more than one public health or clinical data registry. Also notice that for MU Stage 3 and MIPS, registries are classified as public health registries and non-public health or rather clinical data registries.
Health IT Workforce Curriculum Version 4.0

9. EP MU Stage 3 (Cont’d – 1)
Must be in active engagement with a public health authority to submit data for three of the following:
Measure 1 – Immunization Registry Reporting
Measure 2 – Syndromic Surveillance Reporting
Measure 3 – Electronic Case Reporting
Measure 4 – Public Health Registry Reporting
Measure 5 – Clinical Data Registry Reporting
Measure 6 – Reportable Lab Results Reporting
2017 OPPS rule may change to two out of six
Similarly, Meaningful Use Stage 3 requires eligible providers to attest to three out of six public health measures. However, the 2017 O-P-P-S rule may change it to two out of six. The measures are: Measure 1 – Immunization Registry Reporting, Measure 2 – Syndromic Surveillance Reporting, Measure 3 – Electronic Case Reporting, Measure 4 – Public Health Registry Reporting, Measure 5 – Clinical Data Registry Reporting, and Measure 6 – Reportable Lab Results Reporting. Note that eligible hospitals and eligible provider requirements are very similar except that reportable results reporting is only applicable for hospitals.
Health IT Workforce Curriculum Version 4.0

10. Active engagement
Means “the process of moving towards sending "production data" to a public health agency or clinical data registry, or is sending production data to a public health agency or clinical data registry”
Possible states:
Completed registration to submit data
Testing and validation
Production
Both the Meaningful Use and MIPS (rhymes with tips) rules require that the hospital or doctor be in active engagement with a public health authority. Active engagement means “the process of moving towards sending "production data" to a public health agency or clinical data registry, or is sending production data to a public health agency or clinical data registry.” The possible states of active engagement are 1 – Completed Registration to Submit Data, 2 – Testing and Validation, or 3 – Production. In this way, hospitals and doctors are not penalized if the public health authority is not ready to accept data.
Health IT Workforce Curriculum Version 4.0

11. Unit 3: Data Standards in Public Health IT, Summary – Lecture b
This lecture discussed the public health objective in Meaningful Use Modified Stage 2, Stage 3, and discussed how the public health objective measures play a role in both the Meaningful Use and the MIPS programs
It explains how providers can actively engage with local public health authorities to meet the measures associated with the objective.
This lecture discussed the public health objective in Meaningful Use Modified Stage 2, Stage 3, and summarized how the public health objective measures play a role in both the Meaningful Use and the MIPS programs. It explains how providers can actively engage with local public health authorities to meet the measures associated with the public health objective.

12. Data Standards in Public Health IT References – Lecture b
Accredited Standards Committee X12. Retrieved on July 10th, 2010 from
Agency for Toxic Substances & Disease Registry. Retrieved on July 10th, 2010 from
American College of Radiology national Electrical Manufactures Association (ACR- NEMA).
AHIMA Industry Standards and Activities. Retrieved on July 10th, 2010 from
American Dental Association. Retrieved on July 10th, 2010 from
American Society for Testing & Materials. Retrieved on July 10th, 2010 from
Analysis of Unique Patient Identifier Options Final report.
Association for Information and Image Management:. Retrieved on July 10th, 2010 from
No audio.

13. Data Standards in Public Health IT References – Lecture b(Cont’d – 2)
CCHIT.
Clinical and Laboratory Standards Institute (CLSI). Retrieved on July 10th, 2010 from
Clinical Data Interchange Standards Consortium. Retrieved on July 10th, 2010 from
Computer Security Division Community Security Resource Center. Retrieved on July 10th, from
Designated Standard Maintenance Organization (DSMO). Retrieved on July 10th, from
Gartner Healthcare Presentation. Retrieved on July 10th, 2010 from
Global Patient Identifiers. Retrieved on July 10th, 2010 from
Health Industry Business Communications Council (HIBCC). Retrieved on July 10th, from
HIMSS Health Information Exchange
No audio.

14. Data Standards in Public Health IT References – Lecture b (Cont’d – 3)
HIMSS Overview of HIE & RHIOs.
HL7. Retrieved on July 10th, 2010 from
Institute of Electrical and Electronics Engineers. Retrieved on July 10th, 2010 from
Institute of Medicine Recommendation for a National Chronic Disease Surveillance System
International Organization for Standardization (ISO). Retrieved on July 10th, 2010 from
Mapping and Public Health.
National Council for Prescription Drug Programs.
No audio.
Health IT Workforce Curriculum Version 4.0

15. Data Standards in Public Health IT References – Lecture b (Cont’d – 4)
National Institute of Standards and Technology. Retrieved on July 10th, 2010 from
Nationally Notifiable Diseases Surveillance System. Retrieved on July 10th, 2010 from
Office of Surveillance, Epidemiology, and Laboratory Services.
Public Health Informatics Institute. Retrieved on July 10th, 2010 from Public Health Informatics and Information Systems edited by Patrick W. O’Carroll, William A. Yasnoff, M. Elizabeth Ward, Laura H. Ripp, & Ernest L. Martin, 2003 ISBN
National Information Standards Organization (NISO). Retrieved on July 10th, 2010 from
National Uniform Billing Committee (NUBC). Retrieved on July 10th, 2010 from
No audio.
Health IT Workforce Curriculum Version 4.0

16. Data Standards in Public Health IT References – Lecture b (Cont’d – 5)
Reliable Patient Identification Project.
Sample Universal Healthcare Identifier.
Shapiro, J. S. Evaluating Public health uses of health information exchange.
White Paper Unique Health Identifier for Individuals. Retrieved on July 10th, 2010 from
No audio.
Health IT Workforce Curriculum Version 4.0

17. Unit 3: Interoperability Standards in Public Health IT
This material (Comp 13 Unit 3b) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC This material was updated in 2016 by Columbia University under Award Number 90WT0005.
No audio.
End.