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Most hospitals face public health data exchange challenges

While electronic public health reporting has grown significantly in recent years, hospitals and physicians continue to report barriers to public health data exchange.

As of 2022, 96% of hospitals engaged in at least one form of electronic public health data exchange, according to an ONC blog post.

However, data exchange barriers persist, with about three-quarters of hospitals reporting at least one obstacle to public health reporting in 2022.

The most common challenge was hospitals' perception that public health authorities (PHAs) could not electronically receive information. Hospitals also reported technical complexities and exchange costs as barriers to electronic public health reporting.

ONC data found lower rates of electronic public health reporting across small, rural, independent and critical access hospitals.

Office-based physicians also experience challenges in the exchange of public health data due to a lack of EHR integration.

According to data from the 2022 National Physician Health IT Survey, less than half of primary care physicians (41%) used their EHR to view immunization data from outside their organization.

Several efforts aim to address public health reporting challenges and enhance interoperability across healthcare providers and PHAs, including the following:

  • Investment and funding through the CDC's Data Modernization Initiative.
  • Standards development through USCDI+ Public Health and Helios, an HL7 FHIR accelerator.
  • The TEFCA exchange purpose for secure information exchange between healthcare and public health.
  • The use of health information exchange services to support PHAs' ability to respond to public health emergencies.

Additionally, a new proposed rule from ONC aims to meet the need for greater public health data exchange.

The Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-2) proposed rule builds on existing public health certification criteria in the following ways:

  1. Requires updated standards adoption within existing criteria for information sharing.
  2. Adds certification criteria for new use cases such as transmission of birth reporting data to PHAs, expanded laboratory data exchange, and bi-directional exchange with prescription drug monitoring programs.
  3. Adds certification criteria for "health IT for public health" that adopt most of the same standards and functional requirements as existing criteria to advance interoperable exchange between PHAs and healthcare providers.

"Together, these efforts will help address persistent challenges to public health data sharing by investing in public health infrastructure, establishing a governing approach for nationwide health information exchange and advancing standards to support seamless electronic exchange," the ONC blog authors wrote.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.

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