Page 39 - Driving Public Health in the Fast Lane

The lack of enterprise-wide improvements and sustainable funding creates interoperability
challenges at two levels: 1) within a health department, individual surveillance systems are not
able to exchange information with each other; and 2) health department systems cannot exchange
information with CDC and vice versa. As long as investments are made to siloed public health
surveillance systems, the barriers to seamless and timely data exchange will persist.

3. Absence of EHR Integration with Public Health: A Time Burden for All

EHR implementation throughout the health care community has increased rapid access to
medical records, and has benefited patient care significantly by improving care coordination,
enhancing privacy and security of health data, and reducing medical errors. Information such as
patient demographics, laboratory diagnoses, risk factors, prescriptions, immunizations, previous
treatments, and health care provider notes are stored in EHRs. In addition to clinical decisions, these
valuable data can inform epidemiologic investigations and be de-identified to provide information
on the health of communities, cities, and states. Despite the efforts and success to standardize
and implement EHRs within the health care community, a wide gap remains connecting health
care data to the public health surveillance system. Data standards are different between clinical
care, CDC, and public health agencies, hindering the ability to efficiently share data across the
clinical and public health sectors. Therefore, to share data with public health, health care providers
must field redundant calls and resort to manual data sharing of critical health information that
is otherwise available in the EHR. This results in major inefficiencies, lost time, and a diversion of
clinical resources from patient care. Additionally, this approach diverts public health resources—
technologies to support public health surveillance should facilitate more time for epidemiologists to
focus on epidemiologic functions, or for laboratorians to perform testing.

Road block! Building disease-specific

surveillance infrastructure is redundant

and inefficient.

This is akin to constructing interstates that only allow a specific model of car. Each interstate
has common infrastructure, yet efforts have not been made to utilize a foundational
infrastructure to allow one interstate with lanes for multiple types of vehicles.

Progress Made, but Silos Remain 39