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Health Information Exchange (HIE)

There is growing interest in leveraging available health information exchange (HIE) infrastructures to improve public health surveillance (1). The Health Information Technology for Clinical and Economic Health Act and Meaningful Use criteria for electronic health record (EHR) systems are among the factors driving the development, adoption and use of HIEs. HIEs deliver or make accessible clinical and administrative data as patients are admitted, discharged, and transferred across hospitals, clinics, medical centers, counties, states and regions (2). While several HIE infrastructures exist (3), there is little evidence on the engagement in HIE initiatives by state and local health agencies.

Objective

To characterize state and local health agency relationships with health information exchange organizations.

 

Submitted by uysz on

Hypertension (HTN) is a highly prevalent chronic condition and strongly associated with morbidity and mortality. HTN is amenable to prevention and control through public and population health programs and policies. Therefore, public and population health programs require accurate, stable estimates of disease prevalence, and estimating HTN prevalence at the community-level is acutely important for timely detection, intervention, and effective evaluation. Current surveillance methods for HTN rely upon community-based surveys, such as the BRFSS. While BRFSS is the standard at the state- and national-level, they are expensive to collect, released once per year, and their confidence intervals are too wide for precise estimates at the local level. More timely, frequently updated, and locally precise prevalence estimates could greatly improve the timeliness and precision of public health interventions. The current study evaluated EHR data from a large, mature HIE as an alternative to community-based surveys for timely, accurate, and precise HTN prevalence estimation.

Objective:

To assess the equivalence of hypertension prevalence estimates between longitudinal electronic health record (EHR) data from a community-based health information exchange (HIE) and the Behavioral Risk Factor Surveillance System (BRFSS).

Submitted by elamb on

Reports of infants born with congenital syphilis have increased in the United States every year since 2012. Prevention depends on high performing surveillance systems and compliance with the U.S. Centers for Disease Control and Prevention (CDC) recommendations to perform syphilis testing early in pregnancy, in the third trimester and at delivery if a woman is at high risk, and following a stillbirth delivery. These guidelines exist, because untreated syphilis is associated with adverse fetal outcomes including central nervous system infection and death. Surveillance of congenital syphilis and stillbirth is challenging because available data sources are limited. Assessment of compliance with testing guidelines is particularly challenging, since public health agencies often lack access to comprehensive cohorts of tested individuals as most public health laws only require reporting of positive disease case information.

Objective:

To measure stillbirth delivery rates and syphilis screening rates among women with a stillbirth delivery using electronic health record data available in a health information exchange.

Submitted by elamb on

Effective clinical and public health practice in the twenty-first century requires access to data from an increasing array of information systems. However, the quality of data in these systems can be poor or “unfit for use.” Therefore measuring and monitoring data quality is an essential activity for clinical and public health professionals as well as researchers. Current methods for examining data quality largely rely on manual queries and processes conducted by epidemiologists. Better, automated tools for examining data quality are desired by the surveillance community.

Objective:

To extend an open source analytics and visualization platform for measuring the quality of electronic health data transmitted to syndromic surveillance systems.

Submitted by elamb on

Meaningful Use (MU) Stage 2 public health reporting for Eligible Professionals (EPs) included a menu option for ambulatory syndromic surveillance. Review of currently existing models lead to a collaboration between the Illinois Health Information Exchange (ILHIE) and IDPH to build services that would support the use of the MPI, a database that can uniquely match records across systems. The MPI providers a mechanism for public health to manage multiple data streams, while maintaining confidentiality of health information and supporting the mission of public health to identify patterns of illness, apply effective interventions and conduct program evaluation. This initiative will allow IDPH to extend the use of the MPI to other surveillance domains, including hospital discharge, communicable disease, cancer and extensively drug resistance organism reporting.

Objective

This presentation will describe public health efforts to improve data collection by utilizing technology that supports record linkage through the implementation of the Master Patient Index (MPI). The initial use case will be applied to ambulatory syndromic surveillance at Illinois Department of Public Health (IDPH). It will include applications for incorporating the MPI into currently existing public health surveillance data and benefits to data integration and bidirectional information exchange.

Submitted by teresa.hamby@d… on

The federal meaningful use initiative is a major driver to the establishment of expanded electronic syndromic surveillance capacity across the United States. Much has been documented about the background and requirements for eligible hospitals to achieve the syndromic meaningful use objectives. However, the role and efforts by public health agencies in the syndromic onboarding process, which varies by jurisdiction, is a significant component of the success of meaningful use. 

Objective

This presentation aims to highlight technical approaches, validation activities, outcomes, and lessons learned while onboarding local hospitals through a local health information exchange (HIE) for Meaningful Use Stage 2 syndromic surveillance

Submitted by rmathes on

Public health can harness the power of increasingly available health population data to improve practice and effectively allocate resources to areas of need. The driving forces of Health Information Exchanges (HIEs) and Meaningful Use are changing how public health and the healthcare industry communicate with one another. Through open source interfaces, the ability and power to move this population data from the healthcare world to public health entities is obtainable and sustainable.

The widespread adoption of Electronic Health Records and the formation of Health Information Exchanges has opened up new possibilities for public health monitoring. Since 2009, The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has been developing two public health surveillance systems for chronic diseases. The first is the NYC Macroscope, which is built on a distributed query network (the Hub) of 740 New York City ambulatory practices all using proprietary software from one EHR vendor (eClinicalWorks). The second model, Query Health, still in its initial phase, accesses data collected by Healthix, the largest NYC HIE. This study compares these two models for potential disease surveillance and public health application.

Objective

To compare two clinical surveillance systems in development in New York City, one built on a distributed query network of electronic health records (EHRs) and the other accessing data from a Health Information Exchange (HIE).

Submitted by teresa.hamby@d… on
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