Public health reporting for Meaningful Use may depend on HIEs

With public health measures receiving a higher profile in Meaningful Use Stage 2, government agencies are struggling to connect healthcare providers online to public health agencies at the state and local levels. To some extent, this connectivity may depend on the nascent health information exchanges (HIEs) evolving across the country, officials of the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention (CDC) said at the Health Information Management and Systems Society (HIMSS) conference in Las Vegas last week.

In Stage 2 of Meaningful Use, electronic submission of data to immunization registries--which is on the optional menu in Stage 1--becomes a core measure. Submission of data to cancer registries and other specialized registries joins the optional menu in Stage 2. Both of these are new criteria.

In addition, the immunization registry requirement changes from testing to actual submission of data in Stage 2. The same is true for submission of syndromic surveillance data and reportable lab results, but those two criteria remain optional for eligible providers.

For hospitals, in contrast, all of the above public health measures are core requirements.

Jess Kahn, technical director for Health IT at CMS, observed in the agency's HIMSS session that it's up to the providers and public health agencies to figure out a workable data exchange method. Although some providers are submitting public health data directly, creating individual interfaces with thousands of providers in each state is beyond the capabilities of these agencies, she pointed out.

HIEs can reduce interface costs for both sides by capturing the public health data from local providers, transforming it into the government-approved type of HL7 messaging, and sending it to a state health department or other agency through a single pipe, Kahn noted.

"HIE provides a scalable, low-cost and efficient way for providers to interact with public health agencies," she said.

Seth Foldy, director of the public health informatics and technology program for CDC, said something similar in a preconference session earlier in the week. He noted that, as a result of Meaningful Use, public health is scrambling to meet a sharply increased volume of reporting just as the federal government is reducing funding for public health. The CDC hopes that HIEs will help fill the gap, he said.

The CDC is helping hospitals attest that they're ready to send data to public health health agencies, Foldy said, but has had to concentrate on the larger hospitals first. Meanwhile, the CDC has 200 experts developing a "reportable lab conditions mapping tool" and software to translate messages to the correct flavor of HL7.

To learn more:
- read the Notice of Proposed Rule Making for Meaningful Use Stage 2 (.pdf)
- read the FierceHealthIT coverage of the Meaningful Use Stage 2 announcement at HIMSS