Representatives from public health, health delivery systems and health information technology are working on a project with an ambitious timeline to create bidirectional information flow between public health and healthcare.
The Digital Bridge effort was launched in June 2016 when the Robert Wood Johnson Foundation (RWJF), the Public Health Informatics Institute (PHII) and Deloitte Consulting brought together key members of the public health community, EHR vendors and provider organizations in Chicago.
The stakeholders identified electronic case reporting (eCR) as a natural first step toward achieving the vision. Capitalizing on existing methods for clinical data capture and exchange has potential to increase data consistency, completeness, and timeliness of public health surveillance data, they decided.
An interim governance body is forming this fall, with equal representation from public health, health care delivery systems, and EHR vendors. Workgroups will focus on specific issues and report up to the governance body. These workgroups will seek input from existing eCR and other health data interoperability efforts.
The implementation phase will consist of production sites in various jurisdictions. Production sites, including organizations that are currently exploring eCR, will be recruited by early 2017 and results from these implementations are expected to be available by July 2017.
The Robert Wood Johnson Foundation is serving as the neutral convener for the implementation phase, and John Lumpkin, M.D., M.P.H., a Robert Wood Johnson Foundation senior vice president, is chairing the initial governance body. Deloitte Consulting and the Public Health Informatics Institute are providing program support.
Each of the stakeholder communities made a series of explicit commitments to each other. Public health committed to:
• Develop common trigger codes and a deployable tool that would be used by the vendor and delivery system communities to report cases of reportable conditions to jurisdictions in an automated way;
• Subscribe to common technical standards for the delivery of electronic case reports; and
• Advocate for needed policy and regulatory changes that would enable eCR and digital surveillance.
EHR vendors committed to:
• Work together to develop a common technical standards and solutions for eCR and to enhance those standards and solutions over time as progress is made toward the long-term vision;
• Provide that work in kind to the public health and delivery system communities.
Delivery system participants committed to:
• Participate in proofs of concept;
• Do in-kind work on their EHR systems to enable the data transmission needed for the proofs of concept.
The Robert Wood Johnson Foundation committed to supporting this work through the phase of developing and implementing shared governance and to assist in securing the funding needed to support the proofs of concept through to completion. Representatives from the Centers for Disease Control also committed to seeking funding sources to support the latter. PHII committed to developing a project plan and project management through the eCR proofs of concept.
Participants set up key tasks that would culminate in successful eCR on a timeline that extended from the June meeting to Jan. 1, 2018. Delivery system participants noted that on that date Meaningful Use objectives would include electronic case reporting.
While the initial production activity will focus on electronic case reporting for infectious diseases, the governance principles and the infrastructure improvements that are developed should also be applicable to chronic conditions and other public health issues, according to the organization.
Here is a list of the Digital Bridge participating organizations:
- Association of Public Health Laboratories (APHL)
- Association of State and Territorial Health Officials (ASTHO)
- Centers for Disease Control and Prevention (CDC)
- Council of State and Territorial Epidemiologists (CSTE)
- eClinical Works
- HealthPartners/ Park Nicollet Health
- Kaiser Permanente
- Minnesota Department of Health
- National Association of County and City Health Officials (NACCHO)
- Office of the National Coordinator for Health Information Technology (ONC)
- Partners Healthcare
- Public Health Informatics Institute (PHII)
- Robert Wood Johnson Foundation (RWJF)
- University of Nebraska Medical Center (UNMC)