LAS VEGAS—The Centers for Disease Control and Prevention and the Office of the National Coordinator for Health Information Technology are seeking to more closely tie public health data systems with IT systems at hospitals.
Officials at the two HHS agencies are co-leading a work group to assess the "effectiveness, interoperability and connectivity of public health data systems" used to detect public health threats, such as the COVID-19 pandemic, as mandated by Biden's January executive order. They're required to issue a report summarizing their findings and offer recommendations.
Public health in the U.S. runs into challenges because it's "not really … a system," ONC chief Micky Tripathi said during a session on interoperability at the Healthcare Information and Management Systems Society's trade show Tuesday.
The COVID-19 crisis has shown a spotlight on how public health is a fragmented "constellation of systems," as the federal, state, county, city and tribal systems tend to operate separately from one another, Tripathi said.
While various public systems are partners, there's no central group that brings together and coordinates their flow of information. That's thanks in part to how public health's IT infrastructure is funded separately on different levels, which requires separate programs—including IT, said Dr. Daniel Jernigan, acting deputy director for public health science and surveillance at CDC, at the HIMSS21 session.
"We need to … move to supporting common platforms," Jernigan said.
Public health agency's IT systems also don't integrate easily with electronic health record systems used at hospitals and other healthcare provider organizations. If all of these various IT systems linked together more seamlessly, that could reduce the reporting burden on providers, who wouldn't have to report the same data multiple times to different agencies, officials said.
Providers received financial incentives to adopt and use EHR systems through the Medicare and Medicaid EHR Incentive Programs, today known as the Promoting Interoperability Programs, which were rolled out in 2011. There's no such incentive program for public health departments.
"Though we spent millions of dollars to lay a foundation for EHR systems across the country, we didn't make corresponding investments in our public health systems," Tripathi said.
Jernigan and Tripathi both spoke at HIMSS21 via video conference, with their conversation moderated by Hal Wolf, president and CEO of HIMSS, and Tom Leary, senior vice president of government relations at HIMSS, who were on-site in Las Vegas.
Some provider attendees and company sponsors pulled back from in-person HIMSS21 attendance amid concerns about the COVID delta variant, leading to smaller crowds at sessions and in the exhibit hall.
In a four-person panel on health equity, also Tuesday, Dr. Ivor Horn, Google's director of health equity and product inclusion, participated virtually. In a morning keynote on cybersecurity, which included five panelists, Adm. Michael Rogers, a former director at the National Security Agency and former commander at U.S. Cyber Command, also participated via video conference.
HIMSS this year required all attendees to show proof of vaccination to attend the Las Vegas conference and mandated attendees wear masks while at the show. HIMSS is also hosting a HIMSS21 Digital conference for attendees and sponsors to participate virtually, which runs alongside the show in Las Vegas. While some keynote sessions are streamed live or uploaded to HIMSS21 Digital, most programming offered through HIMSS21 Digital is different from that at HIMSS21 in Las Vegas.
ONC and CDC plan to submit the cross-agency work group's report to the HHS secretary by year-end or early 2022, according to Tripathi. The work group is in the midst of working on a landscape analysis and is beginning to work on the recommendations portion of the report, which they'll be putting together through at least the fall.
Recommendations could include creating a common set of data standards for public health, building off of existing efforts like the ONC's U.S. Core Data for Interoperability—a standardized set of data elements used by many EHR companies. They could also involve ONC working with CDC as ONC develops a roadmap related to adoption of the Fast Healthcare Interoperability Resources data standard.
Lack of data integration isn't a challenge limited to the U.S.
The COVID-19 pandemic highlighted the importance of being able to share data not just within a single country, but also across borders, said Dr. Hans Kluge, the World Health Organization's regional director for Europe, during an interview with Modern Healthcare at HIMSS21 in Las Vegas.
He said WHO is working on standing up a "trans-Atlantic partnership" for digital health, which would establish norms and standards for sharing data. Sharing data on global challenges, such as COVID-19 and climate change, could help to speed research. Standards for digital technologies could also encourage different places to align how they handle COVID-19 vaccine credentials.
"We've seen that the world is a small village," Kluge said. "A virus from one part of the world in a couple of weeks was everywhere."
