by: Noam Arzt, PhD, FHIMSS, President, HLN Consulting, LLC, and Rick Edwards, Director, Iatric Systems, Inc
A public health registry is defined as, “…an organized system for the collection, storage, retrieval, analysis, and dissemination of information on individual persons who have either a particular disease, a condition (e.g., a risk factor) that predisposes to the occurrence of a health-related event, or prior exposure to substances (or circumstances) known or suspected to cause adverse health effects.”
Over the past decades, public health registries have evolved from program-specific, stove-pipe systems often based on aging mainframe or personal computer technologies, to more robust specialized systems using modern database management systems on more reliable platforms. HIEs are well positioned to provide the necessary gateways between public health agencies (and their registries) and others in the healthcare community who both supply and source healthcare data.
How can HIEs and public health agencies work together? Here are a few considerations:
- Transport and Technology: Many states are focusing on their connectivity options through a single state gateway or portal, providing leveraged connections for simpler, less costly, and less complicated data exchange. HIEs can serve as gateways to these State networks and simplify the connectivity required to reach state-hosted registries.
- Data Aggregation: Public health registries tend to be topic-specific, but many HIEs are more comprehensive. HIEs could serve as points of aggregation for health data, combining public health data and local clinical and administrative data into expanded patient- or community-centered views.
- Patient Identity and Matching: Public health registries and HIEs share a core need to develop and implement accurate patient matching strategies and technologies, often with the same patients. Both have significant experience in this domain and can “join forces” to improve identity and matching performance within and between their patient records.
- Onboarding: Both HIEs and public health registries rely on the exchange of information, especially from provider systems. The process of connecting and ensuring the ongoing quality of provider-based data involves significant activity. HIEs and public health agencies can collaborate to ensure that a provider organization (or other entity) has only to onboard once for exchange of information, and they can share the burden of this activity.
The Interoperability Roadmap released for comment by ONC in January 2015 emphasizes the cohesiveness required by the healthcare community to realize its vision of a Learning Health System for the U.S. by 2024. Better collaboration between public health and HIEs – and less redundancy – will go far to enable better interoperability and help stretch HIT funds. To do this effectively, HIEs and public health agencies can:
- Communicate whether you collaborate or not. Whether or not projects decide to collaborate, they need to have open, honest and ongoing channels of communication.
- Leverage where it is sensible. Though Immunization Information Systems and HIEs have evolved quite differently, they share some common objectives and often have differing capabilities. HIEs and public health projects can seek ways to meaningfully leverage each other’s capabilities.
- Seek to complement and not compete or overlap. Take advantage of each other’s relative strengths and weaknesses, striving to compliment instead of compete while also avoiding unnecessary redundancies.
- Strive for coherence from the customer’s point of view. Nothing is worse than a confused client. Public health and HIE projects – whether collaborating closely or not in the delivery of services – can craft service portfolios with clearly stated goals and objectives.
- Be civil and respectful. Everyone thinks they are the best; everyone thinks their approach is superior. One need not always agree, but behavior must be civil at all times. You never know when today’s competitor will be tomorrow’s collaborator.
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