Universal Public Health Node: An Evolution of Health Information Exchange for Public Health in New York

With support from the Center for Disease Control (CDC), the New York State Department of Health (NYSDOH), in partnership with the New York City Department of Health and Mental Hygiene (NYCDOHMH), has undertaken an unprecedented initiative to improve situational awareness and reporting for public health purposes on a state-wide basis through the timely collection, analysis, and evaluation of clinical case information using health information exchange for public health and the emerging standards for the Nationwide Health Information Network (NHIN). This presentation describes the vision and conceptual architecture of the Universal Public Health Node (UPHN) and how New York State will utilize the UPHN to address the critical challenges to nationwide situational awareness through HIE by connecting public health and our clinical-based regional health information organization (RHIO) partners through a common set of standards and services for the bi-directional exchange of data while ensuring appropriate privacy protection. We will also present four novel functionalities of the UPHN that support multiple public health scenarios and are needed to implement and extend the Biosurveillance Use Case and the Minimum Dataset (MDS). These functions generically include the ability to respond to patient-level transactional enquiries (routinely supported by most RHIOs designed for clinical data exchange); generation of line-list reports according to preset criteria (e.g., all patients with a diagnosis of pneumonia); identifying services for de-identifying and re-identifying line-list data for epidemiologic case follow-up; and responding to analytic (e.g., aggregation/ summarization) queries. The UPHN architecture and technical specifications are developed in an open, collaborative process with the RHIO and their technical vendors as a set of technical architecture and standards from which anyone may exchange data regardless of computer system or platform. The UPHN and its services will overcome system incompatibility by translating information into a common data structure and format.