Karen DeSalvo: Make public health infrastructure more data enabled

National Coordinator for Health IT Karen DeSalvo shared her thoughts on the potential of technology and an improved, data-driven infrastructure for public health efforts at the eHealth Initiative's annual conference in the District of Columbia Wednesday.

DeSalvo, who also serves as acting assistant secretary for health at the Health and Human Services Department, talked about both past and present health crises, touching not only on Ebola and Zika, but also the water crisis in Flint, Michigan, in which electronic health records helped identify unsafe lead levels in children.

"[I]n Flint ... Dr. Mona Hanna-Attisha ... is flat out exuberant over her electronic health record," DeSalvo said. "They were able to lift up a public health crisis in that community in very short order and translate that into some action. There are others in that community who also have found that their electronic health record is helping them identify the gaps in screening."

Payers in that community have also been "very engaged" in running eligibility lists for untested children and then reaching out to providers, DeSalvo said.

"The health information that we have, whether it's claims or clinical, is being used in real time today, as we speak," she said.

Consumers and patients, DeSalvo said, increasingly feel "boxed out" from their own data, and want to know that it is available and actionable not only to improve their individual health, but also, when necessary, the health of the community around them.

Regarding Zika, DeSalvo said that she participated in a call with the Centers for Disease Control and Prevention and "some vendors" a few days ago in which the impetus was to start thinking about ways to provide more resources to improve frontline clinical decision support.

"It's incumbent upon all of us as we're thinking about developing tools and prompts that we make them simple and not create added tablet pages ... because that's the last thing that doctors need is extra click boxes," she said. "But on the other hand, I think it could help alert and remind, and we're going to do our best to be nimble so we can update that information as we're evolving. And Zika is going to evolve quickly."

Despite such efforts, however, she said that overall, the current state of public health is behind the times.

"I just don't see how we can continue to have a public health infrastructure in this country unless it's more data and information enabled," DeSalvo said. "We have the information; we need to now ... fulfill that promise. This is about the public's health and not just about the healthcare sector."

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