How EHR Systems Improve COVID-19 Public Health Response

Developing, implementing, and assessing a plan for EHR systems and public health information systems require a boost in health IT, governance, and overall strategy, according to a study published in The Journal of the American Medical Informatics Association (JAMIA).

COVID-19 response efforts have included the collection and analysis of individual and community EHR data from healthcare organizations, public health departments, and socioeconomic indicators. But those resources haven’t been deployed the same way in all healthcare organizations, the researchers stated.

“The current state of COVID-19 data reflects a patchwork of uncoordinated, temporary fixes to a historically neglected public safety function,” wrote the researchers. “As the US enters its second decade of nationally-coordinated digital infrastructure for healthcare delivery and to modernize patient care, COVID-19 has demonstrated that this infrastructure is inadequate to respond to public health emergencies.”

Researchers analyzed the COVID-19 response efforts from 15 health organizations that saw delays in correctly understanding, predicting, and mitigating the COVID-19 spread. The research group focused on EHR data. They also outlined the current health IT infrastructure, such as data registries and clinical data networks, and data ecosystem challenges that are relevant to the current pandemic.  

Through that analysis, the research team determined a number of steps that could help organizations in the current and future steps to mitigate the pandemic, which most experts say is in its third wave. The researchers’ recommendations may also help in future public health crises.

Health IT infrastructure needs to support public health that leverages EHR systems and associated patient data, but it cannot be developed and implemented right away, the researchers began.

Additionally, having better control of the timeliness of data analysis will be essential. Because analytic methods do not always give real-time results, it is easy to overlook or underuse EHR data.

“While public health tools for horizon scanning, disease surveillance, epidemiological modeling, capacity planning, ‘hot spotting,’ and targeted intervention strategies (such as isolation or contact tracing in the case of a transmissible pathogen) use as much available data as possible, the speed with which these data are collected, organized and analyzed is slow,” researchers explained.

Researchers also found public health information infrastructure does not currently support larger-scale integration. Due to this issue, health organizations have been largely unable to gather information during the pandemic because it requires multiple data submissions to a number of agencies.  

“Unless COVID-19 data initiatives are coordinated and systems are interoperable, much effort and money will be spent into each initiative individually: these initiatives will compete with each other, will only provide partial answers, and will still not properly support public health decision making for this and the next pandemic, and for other diseases that have a large national impact,” explained study authors.  

If developers create new health IT to fill current COVID-19 data needs, it may not be able to be used for a future pandemic, said researchers. Although health IT developers and public health systems were caught off guard by the current pandemic, both should be ready for the next COVID-19 wave or a future pandemic.

Researchers said the value of boosting technology, governance, and an overall strategy can be analyzed through cost and benefits, but many stakeholders must adapt quickly to these three changes because the cost of optimizing a current health IT system can be overwhelming to health organizations.

“We call all stakeholders to act now to build a coordinated system of data sharing to combat COVID-19, and to prepare for the inevitable next pandemic,” wrote researchers.

“Successful implementation of the measures outlined in this article will enable evidence-based approaches to coordinate testing and contact tracing, predict needed resources and prepare accordingly (so “non-essential” healthcare services will not need to be shut down unnecessarily), conduct basic, preventive or therapeutic research, and provide a trusted, factual basis for answering public health questions of critical importance for this pandemic and other health conditions,” concluded the research team.