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Health Information Exchange (HIE)

The American Health Information Community Harmonized Use Case for the Biosurveillance minimum data set (MDS) was implemented to establish data exchange between regional health information organizations (RHIOs) and the New York State Department of Health (NYSDOH) for accelerating situational awareness through the Health Information Exchange (HIE) Project. However, the completeness, timeliness of the reporting and quality of data elements in the MDS through RHIOs are still unknown and need further validation before we can utilize them for NYSDOH public health surveillance.

Objective

Evaluate the availability, timeliness, and accuracy of MDS data elements received from one RHIO for emergency department (ED), in-patient, and outpatient visits. Compare the characteristics of patients meeting the HIE influenza-like illness definition who were admitted to the hospital or expired versus those discharged home.

Referenced File
Submitted by uysz on

Hospital discharge data received by public health agencies has a reporting lag time of greater than six months. This data is often used retrospectively to conduct surveillance to assess severity of illness and outcome, and for evaluating performance of public health surveillance systems. 

With the emergence of Health Information Exchanges and Regional Health Information Organizations (RHIOs), inpatient data can be available to public health in near real-time. However, there currently are no established public health practices or information systems for conducting routine surveillance in the inpatient setting. 

Through a contract with the Centers for Disease Control and Prevention, New York State Department of Health

initiated the development of a statewide public–health Health Information Exchanges with New York RHIOs. Daily

minimum biosurveillance data set data-exchange implementation, and evaluation efforts were focused on one RHIO (RHIO A) and one participating hospital system composed of five acute-care facilities.

 

Objective

The objective of this paper is to assess the potential utility of inpatient minimum biosurveillance data set data obtained from RHIOs for pneumonia and influenza surveillance.

Referenced File
Submitted by hparton on

Traditionally, public health agencies (PHAs) wait for hospital, laboratory or clinic staff to initiate case reports. However, this passive approach is burdensome for reporters and produces incomplete and delayed reports, which can hinder assessment of disease in the community and potentially delay recognition of patterns and outbreaks. Modern surveillance practice is shifting toward greater use of electronically transmitted disease information. The adoption of electronic health record (EHR) systems and health information exchange (HIE) among clinical organizations and systems, driven by policies such as the meaningful use™ program, is creating an information infrastructure that public health organizations can take advantage of to improve surveillance practice.

Objective: To enhance the process by which outpatient providers report surveillance case information to public health authorities following a laboratory-confirmed diagnosis of a reportable disease.

Submitted by elamb on

During the 2009 H1N1 influenza pandemic, the Washington State Department of Health (DOH) temporarily made lab-confirmed influenza hospitalizations and deaths reportable. As reporting influenza hospitalizations is resource intensive for hospitals, electronic sources of inpatient influenza surveillance data are being explored. A large Health Information Exchange (WA-HIE) currently sends DOH the following data elements on patients admitted to 14 hospitals throughout eastern Washington: hospital, admission date, age, gender, patient zip code, chief complaint, final diagnoses, discharge disposition, and unique identifiers. WA-HIE inpatient data may be valuable for monitoring influenza activity, influenza morbidity, and the basic epidemiology of hospitalized influenza cases in Washington.

Objective

To evaluate the timeliness, completeness, and representativeness of influenza hospitalization data from an inpatient health information exchange.

Referenced File
Submitted by teresa.hamby@d… on

Utah Statewide Immunization Information System (USIIS) is the state immunization registry. It is connected to about 700 organizations, including 100% public health clinics, 60% of private providers, many schools, daycares, pharmacies, and Indian Health Services. Data exchange methods range from web data entry, batch file transfer, proprietary or HL7 data interfaces, and real-time exchange with Intermountain

Healthcare’s electronic health records. Clinicians in Utah ranked immunization data as one of the first five use cases for developing the statewide clinical Health Information Exchange (cHIE) in Utah Health Information Network. Utah Department of Health has collaborated with Utah Health Information Network to develop the immunization information exchange.

 

Objective

The goal of the immunization information exchange is to expand the USIIS interoperability to all private providers, especially those who are not a USIIS’ user but participate in cHIE.

Referenced File
Submitted by hparton on

Given the clear relationship between spatial contexts and health, the Indiana Center of Excellence in Public Health Informatics (ICEPHI) aims to serve both the needs of public health researchers and practitioners by contextualizing the health information of large populations. Specifically, ICEPHI will integrate one of the nation’s largest health information exchanges, the Indiana Network for Patient Care, with well-established community information systems that collect, geocode, organize, and present integrated data on communities in Indiana and surrounding states, including data on public safety, welfare, education, economics, and demographics.

 

Objective

This presentation describes a collaborative approach for realizing the public health potential of a geospatially enabled statewide health information exchange.

Referenced File
Submitted by hparton on

Adoption of electronic medical records is on the rise, due to the Health Information Technology for Economic and Clinical Health Act and meaningful use incentives. Simultaneously, numerous HIE initiatives provide data sharing flexibility to streamline clinical care. Due to the consolidated data availability in centralized HIE models, conducting syndromic surveillance using locally developed systems, such as GUARDIAN, is becoming feasible. During the past year, Chicago has embarked on a city-wide HIE deployment campaign. Perhaps the most unique aspect of this endeavor is that the data warehouse for the HIE is intricately tied to the GUARDIAN syndromic surveillance system.

Objective

The objective is to describe the technical process, challenges, and lessons learned in scaling up from a local to regional syndromic surveillance system using the MetroChicago Health Information Exchange (HIE) and Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification (GUARDIAN) collaborative initiative.

Submitted by elamb on

During the 2009 H1N1 influenza pandemic, the Washington State Department of Health (DOH) temporarily made lab-confirmed influenza hospitalizations reportable. Reporting of influenza hospitalizations is resource intensive for hospitals and local health jurisdictions. As a result, electronic sources of influenza hospitalization data are being explored. A Regional Health Information Exchange (HIE) in Washington currently sends DOH ICD9 coded discharge diagnoses and microbiology laboratory orders and results for all patients admitted to 17 hospitals throughout Washington, including four of the five hospitals in Spokane County. The HIE hospitalization and laboratory data may be a valuable replacement for mandatory notifiable condition reporting to monitor the basic epidemiology and severity of influenza in Washington.

Objective

To evaluate the sensitivity, positive predictive value (PPV), timeliness, completeness, and representativeness of lab-confirmed influenza hospitalization data from a health information exchange with respect to traditional notifiable condition reporting.

Referenced File
Submitted by elamb on

Electronic laboratory reporting (ELR) was demonstrated just over a decade ago to be an effective method to improve the timeliness of reporting as well as the number of reports submitted to public health agencies. The quality of data (inc. completeness) in information systems across all industries and organizations is often poor, and anecdotal reports in the surveillance literature suggest that ELR may not improve the completeness of the data in the submitted reports.

 

Objective 

To examine the completeness of data submitted from clinical information systems to public health agencies as notifiable disease reports.

Referenced File
Submitted by elamb on

One of the significant challenges that multi-user biosurveillance systems have is alarm management. Currently deployed syndromic surveillance systems [1–3] have a single user interface. However, different users have different objectives; the alarms that are important for one category of user are irrelevant to the objectives of another category of user. For example, a physician wants to identify disease on an individual-patient level, a county health authority is interested in identifying disease outbreak as early as possible within his local region, while an epidemiologist at the national level is interested in global situational awareness. The objective of a multi-agent decision support system is not only to recognize patterns of epidemiologically significant events but also to indicate their relevance to particular user groups’ objectives. Thus, instead of simply providing alerts of anomaly detections, the system architecture needs to provide analyzed information supporting multiple users’ decisions.

Referenced File
Submitted by elamb on
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