Taylor Sheryl

The ability to harness data science for use in improving population health and public health surveillance begins with the application of interoperability standards to electronic messaging for data exchange between HIT used by public health authorities (PHAs) and the providers who submit patient data to them. When electronic transmissions between these entities are not based on interoperability standards, the patient data that are exchanged may be incomplete, inaccurate, invalid, and/or untimely. As a result, local PHAs and the Centers for Disease Control and Prevention (CDC) may be unable to fulfill their goals of monitoring public health trends and improving population health.

Objective: To provide tools to generate national and local syndromic surveillance electronic messaging specifications and to test implementations in which the set of requirements have been implemented in order to confirm or refute the conformance to those requirements, thereby promoting healthcare information technology (HIT) interoperability in the public health sector.

Lack of speed, reliability, and uniformity of data collection limit the ability of syndromic surveillance (SyS) systems to provide public health authorities (PHAs) with timely information on community health threats and trends. Electronic information technologies have long been used to accelerate and automate data collection for more real-time surveillance. There is, however, irregularity in how SyS data are packaged and sent by healthcare providers. In the US, federal programs to improve patient and population health outcomes are promoting enhanced EHR technology interoperability with a newly mandated standard for SyS data communication. Under a federal rule tied to Medicare and Medicaid reimbursement rates, hospitals are now required to provide SyS data to PHAs using HL7 2.5.1 messages that are in conformance with the CDC’s Public Health Information Network (PHIN) guide for SyS. Merely mandating this standard, however, does not necessarily mean that it will be used as intended or that EHR SyS data will be interoperable among systems. Technology standards are frequently implemented with inconsistencies that spring from guidance ambiguities or misinterpretations. Inserting thorough conformance testing early in the technology development life cycle can increase the probability of conformance to standards, interoperability, and product reliability while reducing overall costs.

Objective

Describe how the National Institute of Standards and Technology's (NIST) Syndromic Surveillance Messaging Validation Suite supports federal efforts to increase electronic health record (EHR) interoperability for timelier public health surveillance capabilities in the US.