Data Exchange Challenges Impede Electronic Public Health Reporting

The healthcare industry must focus on increasing electronic health information exchange (HIE) to ensure the availability of timely data for public health efforts, according to an ONC data brief.

Survey data from 2019 found that more than 70 percent of hospitals experienced at least one major challenge with electronic public health reporting.

Additionally, less than one in five primary care physicians—and about a quarter of pediatric and internal medicine primary care physicians—reported electronically sharing data with public health agencies.

“It is important to note that ONC’s analysis did not report on physicians’ overall levels of public health reporting—which often occur through manual, paper-based methods—nor does it reflect recent levels of electronic public health reporting which may have improved during the pandemic,” ONC officials Chelsea Richwine and Vaishali Patel emphasized in a HealthITBuzz blog post.

ONC and other HHS agencies are working on initiatives that aim to reduce reliance on paper-based processes and increase the electronic exchange of health information to help ensure the availability of timely data for ongoing COVID-19 response and future public health preparedness.

For example, USCDI+ is a new ONC initiative to support the identification and establishment of datasets to better address needs specific to public health.  

ONC officials noted a silver lining: physicians who electronically exchanged information with public health agencies were more likely to record social determinants of health (SDOH) data electronically.

SDOH information exchange can help support public health surveillance and aid populations disproportionately affected by COVID-19 and other public health threats.

“However, we do not know the extent to which these data were recorded in a structured format that could easily be exchanged,” the blog authors wrote. “Furthermore, given low rates of exchange reported by physicians, it is unclear how often these data were leveraged for public health purposes.”

To improve electronic SDOH data sharing between providers and public health agencies, ONC and its sister agencies support efforts to standardize the collection and exchange of SDOH data for care coordination and public health surveillance.

For instance, ONC recently updated the United States Core Data for Interoperability (USCDI) to enable the standardized, electronic exchange of SDOH and sexual orientation and gender identity (SO/GI) data.

ONC has also supported an SDOH pilot project through Leading Edge Acceleration Projects (LEAP), led by the University of Texas at Austin. The project integrates SDOH data into EHRs to manage the social needs of patients identified in clinical settings.

“While our recent data briefs highlight challenges to public health reporting prior to the pandemic, efforts underway at ONC and HHS more broadly aim to modernize public health data systems and promote the seamless exchange of information (including social and behavioral determinants of health data) among healthcare providers and public health agencies,” Richwine and Patel wrote.

“Together, these efforts will provide both the technical infrastructure and the incentives to better support key public health activities during the ongoing pandemic and in future public health emergencies,” they continued.