The Office of the National Coordinator for Health Information Technology (ONC) recently released a data brief entitled, “Challenges to Public Health Reporting Experienced by Non-Federal Acute Care Hospitals, 2019.” The brief explains that even before the COVID-19 pandemic, U.S. hospitals were struggling to exchange information with public health agencies.
The brief states that “Amidst a global pandemic, the need for efficient exchange of electronic health information between hospitals and public health agencies has never been more critical. To ensure public health agencies have timely and complete data to improve their disease surveillance capabilities, the Centers for Medicare & Medicaid Services (CMS) has established policies that require hospitals to meet specific public health objectives as a condition for participation in the Promoting Interoperability (PI) program.”
Further, “These objectives include submission, and in some cases receipt of data, for the purposes of immunization registries, syndromic surveillance reporting, case reporting, and public health registry reporting. To understand the challenges hospitals faced with public health reporting in the year prior to the pandemic, this data brief uses nationally representative survey data from the 2019 American Hospital Association (AHA) Information Technology (IT) supplement to describe the number and types of challenges hospitals experienced when electronically reporting to public health agencies and how these challenges varied by state and hospital characteristics. While new challenges may have emerged or become exacerbated during the pandemic, this analysis identifies potential ongoing barriers to health information exchange among hospitals and public health agencies and provides insights into hospitals’ readiness to support key public health activities prior to the pandemic.”
Key highlights from the data brief include:
- In 2018 and 2019, half of all hospitals reported a lack of capacity to electronically exchange information with public health agencies
- In 2019, seven in 10 hospitals reported one or more public health reporting challenges
- Small, rural, independent, and Critical Access hospitals were more likely to experience a public health reporting challenge compared to their counterparts
- The types of public health reporting challenges experienced by hospitals varied significantly at the state-level
- In 2018 and 2019, hospitals’ top two public health reporting challenges were interface-related issues and a lack of capacity to electronically exchange information among hospitals and public health agencies
- Approximately one in five hospitals reported issues exchanging information due to differing vocabulary standards
- A similar share of hospitals reported difficulty extracting relevant information from electronic health records (EHR)
- The percentage of hospitals experiencing public health reporting challenges related to interfaces and use of differing vocabulary standards grew slightly, yet substantially between 2018 and 2019
- In 2019, the mean number of challenges hospitals experienced when reporting to public health agencies was 1.37—similar to the number of challenges reported in 2018 (1.31)
- Nationally, more than 50 percent of hospitals experienced one or two reporting challenges, while fewer than a quarter experienced three or more challenges
- Among hospitals that reported only one public health reporting challenge, 60 percent said they experienced issues with either their own or public health agencies’ capacity to electronically exchange information and 21 percent experienced interface-related issues
- Approximately one quarter of hospitals reported that they did not experience any major challenges related to public health reporting
The data brief states that “Understanding the number and types of challenges experienced by hospitals with respect to public health reporting is critical to developing solutions aimed at improving hospital and public health agency capacity to effectively exchange health information. This data brief shows that just prior to the pandemic a majority of hospitals (71 percent) experienced public health reporting challenges that could impact public health agencies’ ability to monitor and respond to disease outbreaks. These findings are consistent with 2017 and 2018 survey findings, suggesting these were not emergent issues.”
The data brief concludes that further research is needed to examine public health agencies’ assessments on barriers to health information exchange and that understanding both hospitals’ and public health agencies’ experiences is essential to improving their capability to exchange. Additionally, greater investigation into hospitals’ capabilities to perform different types of public health reporting could provide insight into the roles of those who are actively involved in facilitating exchange and, therefore, help identify areas for improvement for future public health emergencies.
