Head of ONC: key to data standardization to integrate public health into information sharing infrastructure

Strengthening the country’s public health infrastructure will be an interdepartmental effort within government, and the Office of the National Coordinator of Health Information Technology is carving out its role in data sharing.

Speaking at a virtual health policy event on Thursday, ONC director Dr Micky Tripathi said the agency was working closely with the Centers for Disease Control and Prevention to break the data silos that exist between clinical systems, administrative systems and public health. systems.

During the Covid-19 pandemic, for example, state and local public health entities had difficulty sharing information with the CDC and among themselves between jurisdictions, Tripathi said.

ONC can help further integration in several ways, starting with the Trusted Exchange Framework and Common Agreement, or TEFCA. Released in 2019, TEFCA aims to provide a nationwide governance framework for interoperability. One of the goals of the ONC with TEFCA is to not only allow providers to share information with each other, but also to directly engage public health agencies in this network, Tripathi said.

“[We want to remove] silos and autonomous pipes for public health, [so that] they are part of the general information sharing infrastructure that is already operational, ”he said.

To include public health agencies in this infrastructure will require better data standardization.

For example, the pandemic has made it clear that standardization of laboratory data is sorely lacking across the country, Tripathi said.

“The CDC had identified two very specific lab codes that labs were supposed to use for Covid testing,” he said. “And what was reported by a number of organizations is that public health systems were receiving 200 different types of lab codes representing Covid because there was no monitoring, no enforcement. “

Another area that needs to be improved for true data integration is patient matching.

During the pandemic, public health agencies would receive case reports from hospitals and a separate stream of electronic lab results, Tripathi said. But there wasn’t enough demographic information – and there’s no nationwide patient ID either – to match the data with any certainty.

To help improve data standardization and patient matching, the ONC is working with the CDC to extend the United States Master Data for Interoperability, or USCDI, to apply directly to entities. public health.

The USCDI is a set of standards that EHRs must follow when viewing certain datasets. Extending these standards to public health entities would allow for greater standardization of data and greater interoperability with supplier and laboratory systems, Tripathi said.

At present, the focus is once again on public health and resources are devoted to improving its infrastructure, which will help government agencies achieve their goals. But Tripathi thinks there needs to be a more coherent approach.

“[There is] a historical model of feast or famine that we have known as a country with public health, ”he said. “After crises we tend to inject a lot of money, then that money starts to fall, and then there are long periods between crises where we underinvest in public health systems.”

“And that presents a challenge to making a rational and sustained investment to create the kind of public health information system that everyone living in the United States deserves,” he added.

Photo: karsty, Getty Images

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