ASTP/ONC Highlights Progress on Electronic Public Health Reporting

Although the pandemic highlighted serious public health data infrastructure gaps, a newly released data brief from the ASTP/ONC shows hospitals making considerable progress in electronic public health reporting, although results varied by hospital characteristics. 

Based on a 2024 survey by the American Hospital Association, the data brief found that in 2024 hospitals were engaged in electronic public health reporting for about 6 out of 8 measured reporting types, on average, and nearly all core reporting types including immunization, syndromic surveillance, laboratory, and case reporting.

In 2024, most hospitals submitted data directly through their EHR for core data types, ranging from 71% for electronic case reporting to 86% for immunization registry reporting.

Fully or primarily automated processes were most commonly used to submit data electronically for core data types: immunization (84%), syndromic (82%), lab (78%) and case (61%) reporting.

Newly required and optional reporting for antimicrobial use and resistance (AUR), public health registry, clinical data registry, and hospital capacity reporting primarily occurred through a mix of automated and manual processes. However, about one-third of hospitals continue to use fully or primarily manual processes to submit data for hospital capacity reporting.

However, small, rural, independent and critical access hospitals were engaged in fewer types of electronic public health reporting on average, compared to medium and large, urban, system-affiliated, and non-critical access hospitals.

Despite marked progress towards public health data interoperability, more than 8 in 10 hospitals experienced at least one challenge to electronic public health reporting in 2024. Challenges were highest for electronic case reporting (59%) and AUR reporting (57%), and lowest for electronic lab reporting (48%) and hospital capacity reporting (46%).

ASTP/ONC noted that as in previous years, the most common challenges reported by hospitals overall were the technical complexity of interfaces, transmission, or submission processes (55%) and the perception that public health agencies lack the capacity to electronically receive information.

ONC pointed to several ongoing efforts to improve electronic reporting to public health agencies. Its Health IT Certification program requires developers of certified health IT to enable users to electronically send standardized health data to public health agencies. Also, the United States Core Data for Interoperability (USCDI+) Public Health Initiative is working toward a standardized set of data elements to support public health uses cases and can help improve the availability of critical data needed to support public health action.