This letter from ISDS offers comments on proposed rule for meaningful use Medicare and Medicaid Programs; Electronic Health Record Incentive Program in the Department of Health and Human Services in the Office of the Secretary, 45 CFR Part 170 RIN 0991–AB58.
The purpose of this document is to define the core of PHSS practice and the minimum EHR data requirements widely used to support the core. This recommendation provides the CDC and the Office of the National Coordinator for Health Information Technology (ONC), with business requirements that will support Meaningful Use stakeholders in meeting the Stage 1 public health surveillance objective.
A health information interchange architecture (HIIA) defines the attributes of a data sharing relationship between two parties. In the context of electronic syndromic surveillance (ESS), this refers to the standards, tools, and means to securely transport an ESS message from a sender (typically an Electronic Health Record, or EHR, system from a healthcare provider) to a recipient (typically a public health agency). The HIIA must support the set of business processes defined for ESS in the 2011 ISDS Final Recommendation: Core Processes and EHR Requirements for Public Health Syndromic Surveillance Report 1 and function with the available infrastructures both within public health and the larger healthcare system.
Objective
In support of national efforts to modernize and enhance health information system interoperability for public health purposes, this report seeks to clarify electronic health information interchange requirements for public health syndromic surveillance by providing: • An assessment of various health information interchange architectures for their ability to meet syndromic surveillance business requirements (See Appendix); • A comparison of potential data transport mechanisms; and • Recommendations for data transport to support Meaningful Use implementation
This Frequently Asked Questions (FAQ) document addresses the questions that recurred throughout the development of the ISDS Meaningful Use Workgroup Recommendations.
The Environmental Public Health Tracking Network (Tracking Network) is a national surveillance system that integrates environmental hazard, exposure, and health outcome data into one system. The Tracking Network launched in July 2009, and has since been receiving data from 23 funded state and local health departments, and several national partners, e.g., Environmental Protection Agency. Despite this success, some challenges exist in obtaining more timely and complete data to link risk factors, and assign exposure for health outcomes with long latency periods before their detection.
The Health Information Technology for Economic and Clinical Health (HITECH) Act (2009) facilitates the adoption of electronic health records (EHR) through incentivizing the meaningful use of certified EHR Technology. Meaningful use is a set of specific objectives and data exchange standards that eligible healthcare professionals and hospitals must achieve to qualify for the Centers for Medicare and Medicaid Services (CMS) Electronic Health Records Incentive Programs. Public health agencies in turn need to have the capacity to accept these data in the mandated standard and determine the potential and use of this increased data.
This presentation will discuss how the Tracking Network is exploring the use of EHR to meet Tracking Network surveillance challenges and provide other opportunities to enhance environmental public health surveillance. We will also present some results of these efforts.
Objective
This presentation will discuss how the Tracking Network is exploring the use of EHR to meet Tracking Network surveillance challenges and provide other opportunities to enhance environmental public health surveillance
Speakers will be practicing clinician-researchers discussing needs for and ongoing usage of recent, local epidemiological information for decision support.
Presenters
Andrea Dugas, MD, Attending Physician in the Department of Emergency Medicine, Assistant Professor, Johns Hopkins University School of Medicine
Presenter
Dr. Andrew Fine, Assistant Professor, Boston Children's Hospital, Harvard Medical School
Hosts
Johns Hopkins University Grand Rounds and ISDS Research Committee
Date
December 14, 2012
Our final Meaningful Use Dialogue will provide insight into New York City’s use of ambulatory EHR records. Steve Di Lonardo and Dr. Winfred Wu plan to discuss the potential benefits, limitations and challenges of extracting data from ambulatory settings. In the process of doing so they will explain the impact and variability of workflows on data types and quality. This discussion serves to emphasize the potential that utilizing ambulatory data may have in complementing other data sources.
Presenters
Health care information is a fundamental source of data for biosurveillance, configuring electronic health records to report relevant data to health departments is technically challenging, labor intensive, and often requires custom solutions for each installation. Public health agencies wishing to deliver alerts to clinicians also must engage in an endless array of one-off systems integrations.
Clinical data captured in electronic health records (EHR) for patient health care could be used for chronic disease surveillance, helping to inform and prioritize interventions at a state or community level. While there has been significant progress in the collection of clinical information such as immunizations for public health purposes, greater attention could be paid to the collection of data on chronic illness. Obesity is a chronic disease that affects over a third of the US adult population1 , making it an important public health concern. Both HL7 v.2.5.12 and Clinical Document Architecture (CDA) messages3 can be used to facilitate the collection of HW EHR data. These standards include anthropometric and demographic information along with the option to transmit behavioral, continuity of care, community resource identification and care plan information. We worked with vendors participating in the Integrating the Healthcare Enterprise initiative (IHE) in developing, testing and showcasing scenarios to facilitate system development, increase the visibility of HW standards and demonstrate potential usages of obesity-related information.
Objective
To demonstrate the feasibility of using healthy weight (HW) IT standards in public health surveillance through the collection and visualization of patient height, weight and behavioral data.