HHS wants automated public health reporting

Health and Human Services secretary Mike Leavitt wants health care providers to have the capability, within one year, to transmit three types of data as part of nationwide public health information reporting.

The categories of data, which would represent less than 24 hours of collection, would be emergency department visits, hospital capacity and lab results. Initially, only providers who already use electronic health record systems would transmit such data in standardized format and cleansed of personal identifiers to state public health agencies and the federal Centers for Disease Control and Prevention (CDC).

'This would be a quantum leap from what we have now. The system we have now is not adequate,' Leavitt said yesterday at the second meeting of the American Health Information Community, a public-private group which Leavitt leads. AHIC will decide on standards and uses for health IT to enable physicians to exchange medical information. Leavitt leads that organization.

Leavitt urged quick improvement in public health reporting because the country faces the threats of possible bioterrorism and pandemic flu.

Instead of waiting for all providers to have the capability to electronically report data, Leavitt urged the group to request data from providers and cities that already have the capacity.

Meanwhile, AHIC will work toward the long-term goal of nationwide public health information reporting by encouraging adoption of health IT, deciding interoperability and content standards and helping to budget for an increase in the IT capacity of state and local agencies.

'The current reporting system can take as long as 26 days. But that is not what really goes on in an emergency; people get on the phone,' said John Loonsk, acting director for the Office of Interoperability and Standards in HHS' Office of the National Coordinator for Health IT. Previously, Loonsk was associate director for informatics at the CDC.

Currently, the CDC accepts reporting on disease-specific systems and one for all reportable diseases.

Leavitt said he was prepared to propose a rule that providers must use certain standards for reporting once those standards are set. Standards would assure public health officials that the data they received were formatted in the same form and were based on standard definitions.

'Identifying the unique event out of a sea of information is where standards are important,' said CDC director Julie Gerberding, one of the 26 AHIC members.

Large, networked hospitals and physician practices are capable of providing those categories of data now, she said. For example, the Veterans Affairs and Defense departments' medical facilities, the New York City Department of Public Health and Hygiene, some large employer health plans, and large heath care companies such as the Cleveland Clinic and Kaiser Permanente, are capable of transmitting the three categories of data.

'We know large hospitals are the early adopters, but they would also be the hubs in such events,' Gerberding said.

AHIC will decide the early uses of health IT on which to focus. During this meeting, AHIC decided on what details it would focus in advancing health IT use for bioterrorism surveillance, personal electronic health records, chronic disease management, quality monitoring and electronic prescribing. Leavitt would like to see initial capabilities that already have a lot of work completed in those use cases to be implemented within 12 to 18 months.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.


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