Acute care hospitals made progress automating public health reporting through electronic health records and other key reporting metrics last year, American Hospital Association survey data shows.
But challenges persist, according to a new analysis of that data from the Assistant Secretary for Technology Policy and the Office of the National Coordinator for Health at HHS.
WHY IT MATTERS
Hospitals are required to submit data to public health agencies for clinical surveillance and immunization tracking, to provide lab results and to achieve electronic case reporting.
ASTP/ONC's most recent data brief describes the state of non-federal acute care hospitals’ engagement in electronic public health reporting, submission processes and ongoing challenges related to evolving regulations. The agency used AHA's 2024 survey data, conducted between April and September, for its analysis.
Of note, hospitals were required to report antimicrobial use and resistance (AUR) data from the onset of 2024 while voluntary hospital capacity reporting that began in May became mandatory again on Nov. 1.
Nearly all hospitals were engaged in electronic public health reporting directly through their electronic health record system for required data types. Largely consistent with years past, 86% of responding hospitals told AHA they were sending immunization registry data through automated processes.
Three-quarters of hospitals were electronically reporting AUR data shortly after it became required, the agency said.
However, a mix of automated and manual methods were used for the optional reporting types. Small, rural, independent and critical access hospitals, for example, reported fewer types of electronic public health reporting.
In AHA's survey, hospitals provided feedback on their current EHR systems and addressed interoperability challenges and difficulties with the adoption of patient engagement tools.
"More than eight in 10 hospitals experienced at least one challenge to electronic public health reporting in 2024," the agency said in the analysis, which is fairly consistent from two years prior. In its 2023 report to Congress, the agency said, "About three-quarters of U.S. hospitals reported experiencing at least one challenge to electronic public health reporting in 2022."
More than half of hospital respondents in 2024 cited complex interfaces or transmission or data submission technicalities. As a result, 50% of hospitals perceived that public health agencies cannot receive electronic information.
Their greatest reported challenges were for electronic case reporting at 59%, followed by AUR reporting at 57%. Their lowest reported challenges were for electronic lab reporting at 48%, followed by hospital capacity reporting at 46%.
One-third of hospitals also said they faced challenges related to onboarding and costs for various reporting types, while a quarter struggled to extract necessary information from their EHR.
On a positive note, fewer hospitals cited barriers, such as differing data element standards.
In its new data brief, ASTP/ONC cited several federal initiatives underway that could further improve public health data exchange, including its Health IT Certification Program, the Trusted Exchange Framework and Common Agreement exchange program, the USCDI+ Public Health Initiative developing standardized data elements for public health use cases and the U.S. Centers for Disease Control's public health data strategy.
Promoting common data standards, including FHIR-based exchange, could also streamline automated reporting and facilitate bi-directional data exchange with public health agencies, the agency added.
Overall, AHA's annual survey had a 51% response rate for non-federal acute care hospitals. The organization's IT supplement specifically tracked hospitals’ engagement in interoperability and exchange, public health reporting, and advanced analytics.
THE LARGER TREND
If one asks Anne Snowden, HIMSS chief scientific research officer, the importance of connecting data to population health to improve outcomes at the state level cannot be understated. HIMSS, the parent company of Healthcare IT News, works with public health officials on data maturity and measuring it.
While the need to track infectious diseases is an obvious purview of public health, the need to understand the rates of other factors affecting populations is just as critical, Snowden said.
"We don't necessarily have the digital infrastructure to inform and proactively identify where the health threats to our population are," she pointed out.
To mitigate population health risks, the healthcare sector and public health agencies must first solve their data infrastructure and exchange challenges.
ON THE RECORD
"Continued public-private collaboration and coordination is critical to dissolving barriers to public health data exchange and promoting the seamless flow of information between healthcare and public health," ASTP/ONC said in the data brief.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
