Strengthening the national public health infrastructure will be an inter-departmental effort by the government, and the Office of the National Health Information Technology Coordinator is playing its role in data sharing.
ONC director Dr. Micky Tripathi said at a virtual health affairs policy focus event on Thursday that the agency is working closely with the Centers for Disease Control and Prevention to break the data silos between clinical systems, administrative systems, and public health. system.
Tripathi said, for example, during the Covid-19 pandemic, state and local public health entities face challenges in sharing information with the CDC and with each other across jurisdictions.
ONC can help further integration in a variety of ways, the first is Trusted exchange framework and mutual agreement, Or TEFCA. TEFCA was released in 2019 to provide a national governance framework for interoperability. Tripathi said that one of the goals of ONC and TEFCA is not only to enable providers to share information with each other, but also to make public health institutions direct participants in the network.
“[We want to remove] Silos and independent pipelines for sanitation, [so that] They are part of a common information sharing infrastructure that is up and running,” he said.
For public health institutions to be included in this infrastructure, better data standardization is needed.
For example, the pandemic clearly shows that there is a severe lack of laboratory data standardization across the country, Tripatti said.
He said: “The CDC has identified two very specific laboratory codes that the laboratory should use for Covid testing.” “Many organizations report that the public health system has received 200 different types of laboratory codes representing Covid. , Because there is no monitoring, no law enforcement.”
Another area where real data integration needs improvement is patient matching.
Tripathi said that during a pandemic, public health agencies will receive separate feeds of case reports and electronic laboratory results from hospitals. But there is not enough demographic information—and there is no national patient identifier—to match the data definitively.
To help improve data standardization and patient matching, ONC is working with CDC to expand U.S. Interoperability Core DataOr USCDI, directly applicable to public health entities.
USCDI is a set of standards that EHR must follow when displaying certain data sets. Tripathi said that extending these standards to public health entities will allow greater standardization of data and interoperability with suppliers and laboratory systems.
At present, people are re-focusing on public health and are investing resources to strengthen their infrastructure, which will help government agencies achieve their goals. But Tripathi believes that a more consistent approach is needed.
“[There is] As a public health field, our country has experienced a historical feast or famine pattern,” he said. “After the crisis, we tend to inject a lot of money, and then the money starts to drain, and then there is a long time between crises For a while, we underinvested in the public health system. “
He added: “This poses a challenge for rational, sustained investment to create a public health information system that everyone living in the United States deserves.”
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