Using a Regional Health Information Exchange to Facilitate Public Health STD Reporting and Partner Notification

Background:  HEALTHeLINK, the Western New York Regional Health Information Organization, a multi-stakeholder organization created to facilitate health information exchange, can be used by public health for STD reporting and partner notification to more accurately and efficiently improve contact tracing and case reporting.  Methods:  HEALTHeLINK maintains information on a secure data site shared with health care entities and public health departments. As of 2013, HEALTHeLINK has received data from 98% of hospitals and laboratories in the reporting area. HEALTHeLINK has been collecting or aggregating STD information as part of standard reporting. Laboratory, treatment, and demographic data on persons with reportable STDs in Erie County are available to Erie County Department of Health (ECDOH) staff.  Results:  HEALTHeLINK collects 500-600 positive chlamydia and gonorrhea test results each month on Erie County residents. ECDOH Epidemiology staff and Disease Intervention Specialists (DIS) use HEALTHeLINK to determine treatment when not reported and demographic and contact information on cases and partners. By accessing HEALTHeLINK, the percent of reported chlamydia and gonorrhea cases with unknown treatment decreased from 46% (1934/4199) and 19% (344/1791), respectively, in 2006, to 8% (393/5088) and 4% (76/1781), respectively, in 2012. DIS started accessing HEALTHeLINK to perform patient and partner follow-ups in December, 2010.  DIS with available performance data from both before (April 2009 – December 2010) and after HEALTHeLINK adoption (January 2011 – September 2013), increased percentage of cases interviewed from 72% (539/747) to 81% (750/923) and increased percentage of named partners examined from 68% (221/323) to 87% (418/481).

Conclusions: Clinical information exchange that includes public health statistics and information that HEALTHeLINK maintains can provide important information on STDs over a wide geographic area in near real time to public health practitioners. This exchange could translate into improvements in accurate and efficient STD identification, reduction of adverse outcomes, and enhancement of the impact of treatment.