Mark Ciampa is a Principal at Booz Allen Hamilton. With deep expertise in the areas of health IT, public health informatics, children’s health and immunization, and IT program management, he leads a variety of projects for civil health clients.
- How can health information exchange improve public health in the United States and around the world?
-
At a fundamental level, health information exchange (HIE) can improve public health in terms of speed, volume and quality of data that can be leveraged for analytics and research related to public health. For example, access to HIE data can improve the speed of case submission for public health reportable conditions to the public health authorities.
Under the new “meaningful use” rules, public health has a role from an HIE perspective. Doctors and hospitals must be capable of either submitting electronic records to immunization registries, providing electronic syndromic surveillance data, or sending lab results electronically to public health agencies. Speed, transparency, and volume of data all can improve public health research and overall public health. - What have been the biggest challenges to the adoption of health information exchange?
-
A challenge specific to public health is interoperability. There is a huge disparity in data sources, vocabularies and codes, and standards. Standardization is a very complex issue. For example, in public health the concept of electronic laboratory reporting is essential. This enables labs to transmit test results to the appropriate public health partners. The complexity occurs over time as different labs have come up with their own local vocabularies and codes, making it difficult to map and translate to standard codes for use in public health analytics and responses.
Relevance is another challenge for public health. A relatively small amount of funding has gone to public health directly due to the focus on direct healthcare delivery and insurance benefits of health IT. There may be gaps in the health IT continuum because clinical data is captured for clinical care and it’s not always relevant or fully usable for public health. We need more bi-directional communications between the clinical and public health worlds. The national focus right now is on the clinical world, but public health needs to have a seat at the table to realize the full benefits of HIEs and health IT. - How can health information exchange help to reform our healthcare system?
-
A public health program that stands to benefit from healthcare reform is the area of chronic disease prevention, which is the leading cause of death and cost in the healthcare system. Prevention programs will help decrease the number of people with chronic diseases while helping those with chronic diseases live fuller lives. Simple things like increasing levels of physical activity, decreasing tobacco use, eating more nutritious foods, and performing community interventions can significantly impact overall community wellness and create changes in people’s behavior.
Prevention is one key area of public health that converges with the promise of HIE, which can help us identify when an intervention needs to be performed and provide data to evaluate the impact of those interventions. Also, massive volumes of data collected from HIEs and EHRs allow us to conduct macro analyses, which benefits overall population health and lowers overall healthcare costs over time.
You must be logged in to leave comments.