Connecting Public Health to Clinical Care through Health Information Exchange:

Current Activities in Indiana

Shaun Grannis MD MS FAAFPThe Regenstrief Institute, Inc.Indiana University School of Medicine

What We’ll Cover Brief overview of the Indiana

health information exchange and public health environment Data flows/coverage Notifiable condition detection Clinical messaging

Targeted public health alerting Enhancing clinician reporting to

public health Surveillance

The Problem(s)

Data needed for public health processes, including situational awareness processes, are scattered across separate systems

This situation hinders public health's ability to perform situational awareness

HIE's can aggregate and deliver data to support public health practice

The Problem(s) Public health generally lacks methods

for communicating with clinical enterprise that are at once efficient, reliable, consistent, and comprehensive

This situation hinders bi-directional communication capabilities between PH and clinical care

HIE's can facilitate bi-directional communication

Information Exchange

Automated Notifiable Case Detection

Notifiable Condition Detector

InboundInboundMessageMessage

PotentiallyPotentiallyReportableReportable

ReportableReportableConditionCondition

ReportableReportableConditionsConditionsDatabasesDatabases

ReportableReportableConditionsConditionsDatabasesDatabases

Abnormal flag,Organism name in Dwyer II, Value above threshold

Compare to Dwyer I

Record Countas denominator

E-mailE-mailSummarySummary

Realtime Daily Batch

PrintPrintReportReport

ss

To PublicTo PublicHealthHealth

To To InfectionInfectionControlControl

NCD Login Screen

NCD Administration Page

NCD Dashboard Page

Clinical Messaging/Public Health Messaging

Results Delivery – An Illustration

Targeted Public Health Alerting

Enhancing clinician reporting to public

health

Reporting Form

Conclusions

Success Factors Add value (solve

problems) Proceed

Incrementally Re-use existing

processes

Key Questions What’s the

problem? What solution? How does

solution address the problem?

Surveillance

Chief complaint (ADT): Clinical abstract trigger Medication reconciliation trigger Hospital utilization tracking

ICD-9: Clinical Care (EMR) Clinical DSS Quality Reporting

Lab tests: Results delivery Clinical care (EMR)

Notifiable condition detection Public Health processes

Connecting Public Health to Clinical Care through Health Information Exchange:

Current Activities in Indiana

Shaun Grannis MD MS FAAFPThe Regenstrief Institute, Inc.Indiana University School of Medicine