More state and local agencies are funneling public health data into health information exchanges (HIEs), but a lack of funding and technical difficulties have slowed widespread integration.
Connecting public health information systems with existing HIEs can reduce redundant reporting and provide more complete data to help providers coordinate care. But public health agencies are still “in the early stages” of assimilating with HIEs, according to a report by the Office of the National Coordinator for Health IT.
The agency uncovered a number of technical challenges inhibiting HIE integration, including incongruent standards and interfaces that prevent seamless data exchange, variations in local public health codes and inconsistent data quality.
“The variation across public health agencies’ information systems results in interfaces to external trading partners that require individual specification and maintenance,” the report states.
Public health agencies also point to “strained budgets and limited resources” to align IT systems with HIEs, noting that HIE integration is often a “second-tier priority.” Agencies expressed the need for more funding to not only upgrade IT systems, but employ staff to oversee those changes.
ONC highlighted two sources of funding, including a Centers for Medicare and Medicaid Services program that matches 90% of administrative costs. But public health representatives said that program doesn’t cover maintenance costs, raising concerns about sustainability. Meanwhile, funding through the Centers for Disease Control and Prevention (CDC) for specific disease registries actually creates additional hurdles for HIE integration since that money can’t be used to build enterprise-wide data streams.
There have been pockets of success integrating public health data with provider systems. In New York, the Department of Health and Mental Hygiene and the NYU School of Medicine recently collaborated with developers to build an EHR surveillance tool that can track the prevalence of chronic illnesses like diabetes, hypertension, smoking and obesity.,
In June, the CDC announced plans to improve public health data collection and analysis by leveraging hospital EHRs and transitioning its databases to the cloud. Former CDC Director Tom Frieden said the approach opens up the possibility to use "new tools for data analytics, data visualization, and information dissemination."