Meaningful Use and Public Health Chris Wells Public Health IT Director June 30, 2014
Meaningful Use Background Health Information Technology for Economic and Clinical Health Act (HITECH Act) Use Health IT to: Improve health of Americans Improve performance of health care system Components: Designated Office of National Coordinator (ONC) in HHS as lead Funding for health IT infrastructure including HIE Incentives (Medicare and Medicaid) for Meaningful Use Strengthen privacy and security of health information
Meaningful Use Background Meaningful Use Goals: Improve quality, safety, efficiency and reducing health disparities Engage patients and families Improve care coordination Ensure adequate privacy and security protections for personal health information Improve population and public health Meaningful Use Mechanism: Establish standards, technology services and trust to support interoperability Stimulate adoption of interoperable electronic health records Promote the meaningful use of EHRs to improve quality and efficiency
Implications to Public Health Unprecedented opportunity to partner with HIE and population health improvement Meaningful use activities will improve the collaboration between clinical and public health care at local and state levels through: Implementation of electronic reporting to Public Health (immunization, laboratory, cancer registry and syndromic surveillance) Improvement of patient centric preventive care (with preventive careoriented quality care measures) Meaningful Use rules bring attention to the readiness of Public Health agencies for bi directional communication with clinical care providers Meaningful Use will give structure to the development of standardized data elements and messaging implementation guides for MU Public Health measures
Importance of Public Health Public Health collects health information to prevent and contain outbreaks, analyze population health trends, and educate and promote healthy choices for populations Through Meaningful Use, Public Health will be able to respond faster and more effectively to public heath events Increase the ability for Public Health to monitor disease, disabilities, and injuries Faster and more effective response maximizes protections to the population as a whole Earlier responses minimize the economic impacts of public health events More timely responses minimizes unnecessary treatment
CORHIO s Commitment to Population Health CORHIO is the state designated entity for health information exchange in Colorado; started in 2011. We work closely with communities across Colorado to develop and implement secure systems and processes for sharing clinical information CORHIO s ultimate goal is to improve population health Importance of our partnership with the state we share the same goals to make Colorado a healthier state CORHIO s vision under new leadership: population health, not subpopulation health Why Health Information Exchange is important Provides the data to identify gaps in care, supports value based accountable care Gives providers more time with patients spent in a valuable way Decisions about patients: socioeconomics, access to care, previous challenges
Now we ll turn the discussion over to our subject s matter expert to discuss one of the Meaningful Use public health measures
Syndromic Surveillance and Population Health Michele Askenazi, MPH, CHES Director of Emergency Preparedness and Response Tri County Health Department (Adams, Arapahoe and Douglas Counties)
BioSense 2.0 and Users in the U.S.
Syndromic Surveillance in Colorado Why: Syndromic surveillance data will be a core objective of Meaningful Use Stage 2 (MU2) which will be required by Oct. 2014 Improve early outbreak detection and response When: Initiated in 2013 Where: Adams, Arapahoe, Denver, and Douglas counties in Colorado What: Syndromic surveillance required elements Who: Emergency Departments and Urgent Care How: Direct data submission to the health department or Submission through a health information exchange (HIE) vendor
Syndromic Surveillance Objective, Measure and Reporting Standards Objective: Capability to submit electronic syndromic surveillance data through CORHIO or directly to a secure website (BioSense) maintained by the Association of State and Territorial Health Officials, and actual submission. Measure: Successful ongoing submission of electronic syndromic surveillance data from Certified Electronic Health Record (EHR) Technology through CORHIO or directly to BioSense, for the entire reporting period. Ongoing submission must meet these standards: Health Level 7 (HL7) version 2.5.1
Syndromic Surveillance and Population Health Syndromic surveillance data submission is used to improve population health by supporting timely and effective prevention and response Electronic health data transactions and large public health databases can be used for epidemiological analyses Syndromic surveillance information is given to public health decision makers for use in monitoring and mitigating public health treatments The use of near real time syndromic surveillance data enables public health authorities to provide timely assessments of population health and improve situational awareness.
Benefits and Future Data Utilization Corroboration of clinical suspicions Tracking spread of outbreaks and identifying target population Comparison/complementary with other traditional data sources (Colorado Electronic Disease Reporting System) Assessing the likely disease burden of seasonal influenza Monitoring large public events (Bioterrorism) Tracking effects of natural disasters Investigating effects of severe weather (Excessive Heat) Information Control (e.g., determining that a schoolbased outbreak is not spreading/contained
How Do I Get Started? Declaration of Readiness to Receive Syndromic Surveillance Data for facilities in Adams, Arapahoe and Douglas Counties: http://www.tchd.org/pdfs/meaningful_use_declaration.pdf Declaration of Readiness to Receive Syndromic Surveillance Data for facilities in Denver County: http://www.denverhealth.org/for professionals/clinicalspecialties/public health For more information for all facilities/providers in Colorado: http://www.costage2mu.dphe.state.co.us/
Syndromic Surveillance Reporting How can CORHIO help? Hospital EDs and urgent care settings in Denver, Douglas, Adams, and Arapahoe counties sending ADT information to CORHIO can send data to the CDC s BioSense 2.0, where it will be analyzed by local public health agencies. Two hospital systems have production messages ready to go, but we are still struggling with technology challenges. Getting through issues and making progress syndromic surveillance is a relatively new project.
Thank You! If you have questions on syndromic surveillance reporting, here are the folks to contact: Michele Askenazi TCHD 720 200 1444 maskenazi@tchd.org Kate Horle CORHIO 720 285 3235 khorle@corhio.org