Demonstration project also included Centers for Disease Control and Prevention (CDC),
IBM Research and the Public Health Data Standards Consortium
— State public health departments could soon be receiving far faster, more accurate information on the occurrence of some 60 serious ‘notifiable’ conditions, including AIDS, West Nile virus, whooping cough and tuberculosis following a multi-state demonstration project focused on standardizing electronic health information exchange between health departments and medical providers.
OZ Systems, a leading provider of public health information, partnered with the CDC, IBM Research and the Public Health Data Standards Consortium in working with the Delaware and New York state Departments of Health and the San Diego (CA) County Department of Health to successfully test an innovative new approach that addresses problems common in communicating disease data between providers and public health entities. The solution they tested is similar to how income tax reporting software first interacts with a payer’s accounting software, and then confirms that the IRS has accepted the tax return.
Currently, doctors are required to notify a state’s public health department when they diagnose a reportable or ‘notifiable’ condition. However, problems and delays frequently arise when information systems aren’t compatible, when data are received but incomplete, and also because many hospitals and providers still use old-fashioned paper forms they fax or mail back to health departments.
OZ Systems assisted the CDC and public health teams in demonstrating the solution. Here is the classic use case:
- A medical provider has identified a patient with a reportable condition.
- Using an existing EHR system, he or she requests the reportable condition form electronically from public health. In the background, the EHR system sends information already collected about the patient to a forms server.
- The medical provider now sees the state public health, reportable condition form inside his or her own EHR/EMR system. Conveniently, most of the data are already pre-populated in this form from step 2.
- The medical provider verifies the pre-populated data, adds any missing data, and then submits the form.
- The medical provider receives a response that confirms that the report was submitted to Public Health electronically and received by the public health information system.
In this scenario, there are no faxes, no screen captures, no printouts, no guesswork, no phone calls, no delays, no emails, no new software to learn or buy, no websites to register or log in to, and no follow-up to do. The provider’s work is finished.
“Hospitals and providers need to communicate to public health efficiently and effectively, yet frequently their information systems do not speak the same language. This is the first problem,” explained Nitin Kunte, OZ Systems’ standards director and project manager. “Simply solving the communications challenge is only one part of the solution. The second problem is that data required to complete the forms are not always contained in the electronic health record. Clear incompatibilities remain in the ways information is captured, managed and presented in divergent electronic health record systems (EHRs) across 50 divergent state public health departments.”
The pilot program demonstrated the solution’s feasibility. Kunte noted that success resulted not simply from using a single standards-based document. Rather, OZ Systems melds standards together to construct a solution no single standard could solve.
Specifically, OZ Systems coupled the IHE Forms standard (IHE Retrieve Form for Data Capture) to appear within the provider’s electronic health record, thus allowing both automated electronic reporting and manual entry to complete the form, with the HL 7 standard known as CDA. CDA allows representation of clinical information in a structured format (i.e., CDA templates) that is equivalent to commonly used paper forms.
Once the information is correct and complete, OZ Systems’ form manager sends data on to a form receiver that creates the CDA document with the information compatibly expressed and in all the right fields. The CDA document is then forwarded to the appropriate public health agency. Acceptance is quickly relayed from that agency. Kunte added that “Making the RFD and CDA work together work together demonstrates how standards can be orchestrated to arrive at unique solutions.”
According to Dr. Terese Finitzo, OZ Systems CEO, the HIT Standards Federal Advisory Committee recommended CDA in September 2011 as a future direction for electronic data exchanges between clinical and public health information systems for public health reporting.
“The work of this pilot firmly positions OZ Systems as a premier partner for public health agencies who need interoperability tools, not necessarily new data systems,” said Dr. Finitzo. “It is impractical to replace public health programs and systems in a wholesale fashion. What is less disruptive and more fiscally sound is to leverage existing public health systems with tools and technologies that are new and especially standards-based. In this spirit, OZ offers public health these tools to augment and enable new functionality in existing public health information systems.”
About OZ Systems
By developing and implementing the world’s smartest information technology platforms, OZ Systems bridges the information gap and helps children and families thrive through improved data accountability, performance measurement, quality certification, and electronic reporting for public health and early education.
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