Bolstering the nation’s public well being infrastructure might be a cross-departmental effort in authorities, and the Workplace of the Nationwide Coordinator for Well being Info Expertise is carving out the position it’s going to play associated to knowledge sharing.
Talking at a digital Well being Affairs Coverage Highlight occasion on Thursday, ONC head Dr. Micky Tripathi stated that the company is working intently with the Facilities for Illness Management and Prevention to interrupt down the information silos that exist between scientific techniques, administrative techniques and public well being techniques.
Through the Covid-19 pandemic, for instance, state and native public well being entities had challenges sharing data with each the CDC and one another throughout jurisdictions, Tripathi stated.
There are a number of methods through which the ONC can assist additional integration, beginning with the Trusted Trade Framework and Frequent Settlement, or TEFCA. Launched in 2019, TEFCA goals to offer a nationwide governance framework for interoperability. One of many objectives the ONC has with TEFCA is to allow not solely suppliers to share data with one another, but in addition have public well being companies be a direct participant in that community, Tripathi stated.
“[We want to remove] silos and unbiased pipes for public well being, [so that] they’re part of the final information-sharing infrastructure that’s already up and working,” he stated.
To incorporate public well being companies in that infrastructure, there’ll have to be higher knowledge standardization.
For instance, the pandemic made clear that laboratory knowledge standardization is severely missing throughout the nation, Tripathi stated.
“The CDC had recognized two very particular lab codes that labs had been supposed to make use of for Covid exams,” he stated. “And what obtained reported by numerous organizations was that public well being techniques had been receiving 200 various kinds of lab codes representing Covid as a result of there was no monitoring, no enforcement.”
One other space that should see enchancment for true knowledge integration is affected person matching.
Through the pandemic, public well being companies would obtain case experiences from hospitals and a separate feed of digital lab outcomes, Tripathi stated. However there was not sufficient demographic data — and neither is there a nationwide affected person identifier — to match the information with certainty.
To assist enhance knowledge standardization and affected person matching, the ONC is working with the CDC to increase the US Core Knowledge for Interoperability, or USCDI, to immediately apply to public well being entities.
The USCDI is a set of requirements that EHRs should observe when displaying sure knowledge units. Extending these requirements to public well being entities would enable for larger standardization of knowledge and interoperability with supplier and lab techniques, Tripathi stated.
In the meanwhile, there’s a renewed deal with public well being and sources are being poured into enhancing its infrastructure, which is able to assist authorities companies obtain their objectives. However Tripathi believes there must be a extra constant method.
“[There is] a historic sample of feast or famine that as a rustic we’ve had with public well being,” he stated. “After crises we are inclined to inject a complete bunch of cash, after which that cash begins to fall away, after which there are lengthy intervals of time in between crises the place we underinvest in public well being techniques.”
“And that presents a problem for making a rational, sustained funding to create the form of public well being data system that everybody residing in the US deserves,” he added.
Picture: karsty, Getty Pictures