Will public health benefit from working with health information exchanges (HIEs) and the nationwide health information network (NHIN)?  Much has been written about HIEs and NHIN, but public health is often lost in the shuffle of Health Information Exchange.

Health Information Exchanges are being designed and built to share clinical information between providers.  Public health agencies are both providers (usually in County Health Departments), and researchers, especially at the state departments of health.  Having worked for 10 years at the Minnesota Department of Health, I came to appreciate how important these state health agencies are to keeping the population healthy.  For example, did you know every state health department has an investigative team that carry beepers, ever vigilant to investigate fast moving disease outbreaks?  When an outbreak happens this team will work up to 24 hours a day to determine why groups of people suddenly become ill (getting to the bottom of food-borne or infectious disease outbreaks). These teams are the unsung heroes of our public health agencies, working constantly to keep us all healthy.

So, how will HIEs help public health, and vice versa?  Information is public health’s lifeblood. The unusual reports of disease and outbreaks are critical to finding and solving health problems affecting the population.  Disease and outbreaks are typically reported second-hand, from calls in emergency rooms, to “disease report cards” that every state gets via the mail from providers.

Imagine a world where every provider automatically reports disease outbreaks or unusual problems directly to state health departments, through their health information exchange.  This electronic reporting process would dramatically speed up the investigative response times for outbreak, whether the outbreak is a food poisoning incident at a restaurant, or a bio-terrorism event in the water supply.  Additionally, once we have this type of data flowing in to public health, we can develop sophisticated software to “watch” for disease outbreak patterns (across multiple emergency departments, for example).

HIEs can speed up reporting to local, state, and national public health agencies.  Reporting of infectious diseases, outbreaks, and even bio-terrorism are critical to public health agencies.  With the ability of NHIN to connect HIEs, healthcare reporting should no longer siloed by provider or region.  HIEs can aggregate and report to public health agencies both locally and nationally.

HIEs can also consume data from public health — a good example is immunization registries.  Image the impact on an Urgent Care provider if they could query the state immunization registry on a 6 year old patient who walks in for care after business hours.  Instead of guessing what immunizations the child has had, the provider could query and obtain the necessary immunization information quickly and easily (and electronically, through the HIE).

Public Health and HIEs working together are important to all of us.  With technologies like NHIN and its ability to link HIEs together, public health data can flow more freely to foster better public health.