To help contain the spread of the COVID-19 pandemic, health IT professionals are focusing on enhancing interoperability.
To make this happen, Duke-Margolis Center for Health Policy assembled a group of health IT professionals and stakeholders to put together a list of recommendations for public health programs to work better with providers, clinical laboratories, and developers to improve patient data exchange and interoperability.
Improving interoperability is a major factor to the success of containing the virus. Along with interoperability, the containment also hinges on learning valuable information in regards to testing, contact tracing, and detecting outbreaks. Improving these factors is crucial as the country begins to open in the near future.
“But public health, health care, and testing organizations have never had to work together with the scale or urgency required for COVID-19 containment,” wrote the authors of the report. “In particular, public health agencies are facing difficulties routinely accessing critical data from these other key participants in the containment effort, despite valiant attempts to cobble together information from many disparate systems.”
The authors, who included the likes of current Aledade founder and former ONC head Farzad Mostashari, MD, and Mark McLellan, the Margolis Center director, identified three short-term, viable steps to improve interoperability and patient data exchange by first identifying two realistic principals.
First, the Mostashari and McLellan want the providers, laboratories, and developers should focus on the short-term, specifically the next 30 to 90 days, rather than the long-term. Even though there are long-term health IT projects that could be worked on, the writers say it is crucial to work on current interoperability projects that need quick solutions.
Next, instead of building new EHR systems, the writers suggested optimizing current systems with pre-existing infrastructure. Because short-term goals are more valuable during this time, optimization rather than rebuilding from scratch saves time and effort to concentrate on current tasks.
With those two principals in place, the group of stakeholders established three rapid recommendations for public health programs to work better with health IT professionals.
First, the stakeholders called for improved commercial lab reporting that would allow for public health tracing of positive COVID-19 cases. These reporting systems would include demographic information at the time of the test. The stakeholders say this testing should range from commercial laboratories, test implementers, and point-of-care testing manufacturers.
The pair also say the Centers for Medicare and Medicaid Services (CMS) and private payers should also establish incentives and payment adjustments that would provide missing information for the providers that conduct COVID-19 tests.
Next, state and local health officials should supplement case investigations with clinical data. This would allow officials to set minimum data use for a COVID-19 containment use case via onboarding.
“The trust framework governance entities that oversee secure data exchange should adopt policies necessary for universal responses to authorized public health queries, in a manner that is fully transparent to all participants and fully auditable,” the writers explained. “State and local public health officials should evaluate and choose a portal-based connector as an on-ramp to access data, ensuring they meet key functional and security criteria.”
Finally, stakeholders recommend enhancing the use of the National Syndromic Surveillance Program (NSSP). This would make a consensus set of data protocols based on federal, state, and local public health officials.
Once these protocols are agreed upon, lawmakers can decide which data from NSSP state lockers can be used at the federal level and surveillance.
Stakeholders say the Federal Department of Health and Human Services (HHS), Office of the National Coordinator for Health IT (ONC), and the Centers for Disease Control (CDC) should implement a governing group of state, territorial, and local officials to review the Syndromic Surveillance Messaging Guide and give it a COVID-19 update.
“This revision should expand the use of the admission, discharge, and transfer (ADT) transactions for syndromic surveillance by encouraging activation of inpatient ADT feeds and sending of additional ADT message types, such as A06 (‘change an outpatient to an inpatient’),” Mostashari and McLellan wrote.