For attendees of the second day of the three-day Public Health Informatics Virtual Event (PHIVE), it was a glass half empty and a glass half full. Participants heard some encouraging presentations about how local public health agencies are starting to take advantage of health information exchanges to improve their investigations of reportable diseases. Yet they also heard the results of a report highlighting the wide array of technological and funding challenges facing those working in public health informatics.
On the positive side, Christine Steward, an epidemiologist in Sedgwick County, Kansas, which includes Wichita, described how her public health organization has made the Kansas Health Information Network the center of its disease investigations. Its epidemiologists can query the HIE from their desktops, and Steward said it has shortened the time it takes to get information on patients for follow-up after initial information about a notifiable condition. A survey of epidemiologists using KHIN found that the average access time using KHIN was six minutes compared to 13 hours via phone and fax traditionally. “Our HIE is already a valuable resource for investigations and is decreasing the time it takes to access patient information,” she said.
Brian Dixon, Ph.D., an assistant professor of health informatics in the Indiana University School of Informatics and Computing, described a study that aims to leverage an electronic lab reporting-EHR-HIE infrastructure to pre-populate notifiable-disease report forms with clinical, lab and patient data. He talked about how the intervention has the potential to streamline reporting workflows, lower barriers to reporting, increase data completeness, improve reporting timeliness and capture a greater portion of communicable disease burden in the community.
But all is not well in public health IT. Marcus Cheatham, the assistant deputy health officer at the Ingham County Health Department in Michigan and co-chair of the Joint Public Health Informatics Task Force (JPHIT), detailed a report completed earlier this year by the independent research organization NORC at the University of Chicago under contract to the Assistant Secretary for Planning and Evaluation of Health & Human Services. It found, among other things, that most public health departments have not yet developed models to access and use provider-generated data, to monitor processes of care or outcomes or assess the status of vulnerable populations. The HITECH Act has created possibilities for progress, but also has pointed out gaps in readiness.
“Public health is on a highwire,” Cheatham said. “Funding of public health IT is dysfunctional, the report notes.” It is episodic in nature and difficult to sustain. The report says there is a need for a systematic overhaul of funding for public health technology. “This report zooms in on what the issues are,” Cheatham said “It is a call to arms.”