Demonstrating Interoperability: Public Health Practice in a Model Health Information Exchange

At the annual Health Information Management and Systems Society (HIMSS) meeting, the Integrating the Healthcare Enterprise (IHE) initiative sponsors the Interoperability Showcase where Healthcare Information Technology Standards Panel (HITSP) interoperability specifications can be demonstrated.  At HIMSS 2009, a collaboration among academic institutions, vendors, and providers, funded in part by the CDC, explored the feasibility of enhancing biosurveillance by using interoperability specifications within a model Health Information Exchange (HIE).   We demonstrated several patient visits during the course of a Salmonella outbreak as well as the behind-the-scenes activities of local, state, and federal public health agencies as they monitored the outbreak and initiated alerts to providers.  The IHE infrastructure enhanced communication including the sharing of medical summary and laboratory documents with public health, the transmission of alerts between public health and providers, and the reporting of notifiable conditions.

First, outbreak detection was facilitated by visualization of the HIE’s laboratory data by the state public health agency.  The outbreak was detected and an alert was generated and saved to a repository.  Several technical specifications were used to transfer alerts from public health to providers during the outbreak, each allowing the public health alert to reach the provider through a clinical system.

The project successfully illustrated the feasibility of utilizing an HIE infrastructure for outbreak detection, alerting, and other public health functions. The demonstration allowed for speculation on the utility of such methods, but ongoing work to examine utility and outcomes in both clinical and public health settings is necessary.  In this presentation, we will describe the biosurveillance scenario demonstrated and all methods of communication used therein, including the three different technical specifications used to enhance communication between public health and clinical providers.   We will also discuss ongoing work to test these methods in real-world public health and clinical settings.