There are many areas of potential overlap between health departments and most HIOs. Health departments have been an important voice in the evolution of early HIOs, and continue to play several key roles in the development of HIE services and use cases.
Given their roles in monitoring health, mobilizing partnerships and improving health services, local and state health departments are often important facilitators for HIOs. They bring two key advantages to the process:
- They can play the role of neutral convener among healthcare providers who are in competition with one another.
- Public health grants can sometimes provide implementation funding for certain exchange use cases.
Health departments are core information users. Examples of the types of information used include the standardized reports listed among the Population and Public Health Meaningful Use objectives of the EHR Incentive Program, such as:
- Laboratory results for reportable illnesses;
- Syndromic surveillance of healthcare utilization for various symptom complexes;
- Immunization events to populate immunization information systems; and
- Reports of cancer incidence and treatment through cancer registries.
In some jurisdictions, HIOs are critical suppliers of this type of information reporting (see Case Study #1 for an example). Some health departments are creating community-level registries to support coordinated clinical and community management of health risks, like obesity or asthma (see Case Study #2). Some are even participating in efforts to leverage HIE to support public health nurse support for diabetes care, school nurse participation in asthma care plans, and to enhance information availability for EMS professionals, all in non-medical settings (see Case Study #3).
Health departments are also important information contributors. Some offer laboratory and diagnostic services, and many still provide clinical services - ranging from immunizations and comprehensive primary care to home health services - without which a community health record would be incomplete. Health departments may also provide substantial immunization information, information about community health resources, alerts about outbreaks and other emergencies, decision support tools and other information valuable to other HIE users.
Transformers of Healthcare
Finally many health departments play a critical role in the transformation of healthcare in communities. In this role, they may work with HIOs in developing use cases to achieve:
- better multi-disciplinary or multi-organizational team care;
- better healthcare access, navigation and coordination; and
- linking patients with community-based services.