The Impacts of the Affordable Care Act on Preparedness Resources and Programs Workshop Summary (2014) / Chapter Skim
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6 Potential Opportunities to Enhance Preparedness Through Health Information Exchanges and Predictive Analytics
6 Potential Opportunities to Enhance Preparedness Through Health Information Exchanges and Predictive Analytics
Pages 61-74
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From page 61... ...
Unless states and regions plan ahead for the ability to access each other's health information exchanges, the exchanges will not achieve their full potential for data sharing. • Improved surveillance and threat detection involves automated, real time access to electronic health records to collect laboratory and syndromic surveillance data and conduct ad hoc queries (including the flexibility to query for elements that may arise in a disaster)
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From page 62... ...
Participants in the HIE across the state include hospitals, clinics, and federally qualified health centers, as well as physician practices, dental clinics, optometrists, substance abuse centers, community mental health centers, home health organizations, safety net clinics, pharmacies, hospices, long-term care facilities, laboratories, behavioral health providers, public health departments, and schools. Currently there are 367 KHIN members that are, or will soon be, sending data for more than 1 million unique patients to the exchange.
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From page 63... ...
SOURC CE: McGuire presentation, p November N 19, 22013. McGuire descrribed several of the servicces KHIN haas available, ffor exampple, secure cliinical messag ging for comm munication aand information exchannge among prroviders, heallth informatioon exchanges, and electronnic health record vend dors.
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From page 64... ...
does not require the use of any particular vendor, so for example, Kansas City spans the Kansas-Missouri border, and each state uses a different vendor for sending syndromic surveillance information to CDC. Interfaces are costly and time consuming, and hospitals in Kansas, for example, currently need to pay for and institute both HL72 interfaces to send data to public health, and Continuity of Care Document interfaces for Meaningful Use compliance.
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From page 65... ...
State health departments have a statutory mandate to collect surveillance data, including vital records data and other health data. In New York, the state health department is the health system regulator, operates the state Medicaid program and the state health exchange, is the shared lead agency in health emergencies, and is a source of expert medical guidance to the health care community.
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From page 66... ...
Improved surveillance and threat detection involves automated, realtime access to EHRs to collect laboratory and syndromic surveillance data and conduct ad hoc queries (including the flexibility to query for
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From page 67... ...
There needs to be bi-directional information exchange and real-time guidance and decision support for conditions of public health interest, he concluded. PREDICTIVE ANALYTICS IN PUBLIC HEALTH PREPAREDNESS The ACA provides a very important opportunity to improve the uptake of EHRs and the ability to use the data in them; to improve surveillance methods and use these data for improved models, analysis, and decision making; and to improve service delivery through public and private partnerships, said Brandon Dean, staff analyst for the Los Angeles County Department of Public Health.
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From page 68... ...
Pandemic Modeling Dean described two models that were explicitly designed for local health departments to understand the spread of pandemic influenza within the community and the effect on the hospital systems (see Figure 6-2) , and to use that information to drive local planning and policy development.
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From page 69... ...
Itt was also cllear there woould be uneqqual impacts in s of the hoospital, local ppopulation, annd differeent regions, based on the size other factors. f Anthra ax Modeling An nother examp ple described d by Dean involved meedical counteermeasuures for anthrax exposure.
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From page 70... ...
Using de-identified data from health records and insurance records, the goal of the tracking program is to build profiles of what these particular groups will need in an emergency and to work with the public and private providers to coordinate pharmaceutical care services for these individuals during a crisis to prevent the ad hoc provision of medications that often occurs at the local level currently at various emergency shelters. Ideally, this could help to inform real situations that Dean described in his simulations.
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From page 71... ...
The study found that key challenges for local health departments were access to information on private retail supply, confusion regarding the use of public versus private sources of antivirals, and tracking of antiviral use (Hunter et al., 2012)
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From page 72... ...
SOURCE: Hupert presentation, November 19, 2013. Public- and Private-Sector Integration Hupert noted that he had not found provisions in the ACA addressing the integration of private health care sector information systems into public health response, and this will need to be considered if public authorities are going to maximize the capability at the local level of providing countermeasures in an emergency scenario, as previously described.
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From page 73... ...
As the ACA is being implemented, it is an opportune time to bring together the people who run the various health information systems and make sure that public health is part of the system, he concluded. Incorporating Modeling into Everyday Health Decision Support Many participants also discussed how health care and public health decision makers, with numerous competing priorities for their time and resources, could use existing HIEs for decision support without the need to build or rebuild models for each new situation.
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From page 74... ...
A challenge for public health preparedness is that modelers are dealing with such potentially rare events that would not impact people's daily lives like weather does. Cairns countered that North Carolina is tracking emergency health records across entire populations, collecting data on health care encounters every day.
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