MedicalResearch.com Interview with:
Dawn Heisey-Grove, MPH
Office of Planning, Evaluation, and Analysis
Office of the National Coordinator for Health Information Technology
U.S. Department of Health and Human Services
Washington, DC 20201
Medical Research: What is the background for this study?
Response: To complete outbreak investigations and perform tasks geared towards improving the public’s health, public health agencies need clinical information from hospitals and health care providers. Adoption of electronic health records (EHRs) and other health IT has made it possible to shift from time-intensive, paper-based public health reporting to electronic information exchange, which enables sending more complete information to public health agencies faster.
Such electronic information exchange with public health agencies is a component of the Medicare and Medicaid EHR Incentive Program meaningful use attestation process. Hospitals in the first stage of meaningful use must select at least one of three optional public health measures to report: immunization registry reporting, syndromic surveillance reporting, and electronic laboratory results reporting. Hospitals in the second stage of meaningful use are required to report on all three public health measures unless there is a valid exclusion.
Medical Research: What are the main findings?
Response: Using 2014 data from the Medicare EHR Incentive Program, we found that stage 2 hospitals were electronically reporting to local public health agencies more than stage 1 hospitals. Nationally, almost 75% of stage 2 hospitals were able to report all three measures to public health agencies, compared to only 5% of stage 1 hospitals. Stage 2 hospitals had very high rates for electronic exchange with public health agencies across all three measures. Specifically, immunization registry reporting among stage 2 hospitals was highest at 88%, 85% were electronically submitting lab results, and 75% successfully reported the syndromic surveillance measure.
Medical Research: What should clinicians and patients take away from your report?
Response: These data clearly demonstrate that public health agencies and hospitals are capable of exchanging electronic health information. There is also a distinct difference in hospital reporting behavior when public health reporting is optional (stage 1) versus required (stage 2) – hospitals in stage 2 reported higher rates of public health electronic information exchange than those in stage 1.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: The recommendation is to increase research focused on the completeness of data sent to public health agencies and perhaps most importantly, how public health agencies are using these data to improve the public’s health. This is a new arena for public health agencies, and watching the impacts of this enhanced information exchange should be very interesting over the next few years.
The second area in need of additional research involves the next stage for electronic public health reporting, which is bi-directional exchange between public health agencies and hospitals. Our findings represent exchange in a single direction – hospitals sending information to public health agencies. As health IT matures to enable exchange between the two entities, public health agencies could request information necessary for case follow-up, hospitals and clinicians could respond electronically, and the speed with which public health agencies would be able to conduct investigations would improve dramatically. Faster investigations means faster preventive treatments, less disease spread, better outbreak control, and ultimately, a healthier population. Research that explores how to facilitate bi-directional exchange, as well as the impacts of that exchange, should yield many interesting findings.
Heisey-Grove, D., Chaput, D., Daniel, J. (March 2015) Hospital Reporting on Meaningful Use Public Health Measures in 2014. ONC Data Brief, no. 22. Office of the National Coordinator for Health Information Technology: Washington DC.
MedicalResearch.com Interview with: Dawn Heisey-Grove, MPH (2015). Electronic Records Facilitating Hospital Reporting Of Public Health Measures