INFORMATICS
Mapping the Complex Future of Public
Health Information
by Martha Pings, writer
Imagine driving on a highway. With each
new town, county and state comes a new
measure of distance. Kilometers, inches,
leagues, rods, light years and furlongs are
used in quick succession. Meanwhile, your
car’s odometer continues its progression
in miles.
Challenging? Confusing? Most certainly.
That’s the risk faced by travelers of the
e-health highway. Without consistent
“rules of the road,” mobilizing health data
is tricky.
The variability of state laws surrounding
the Health Insurance Portability and
Accountability Act (HIPAA) protections
makes for difficult navigation. “The laws
and policies usually are endeavoring to
best protect sensitive patient data, but
they become very complex when they
vary state by state,” says John Loonsk, MD,
FACMI, a national expert in healthcare
technology.
According to Loonsk, the need for
providers and public health officials to
“do no harm” to privacy laws (and incur
no penalties) can result in silence. “There
are plenty of other interoperability issues
as well, but unfortunately, the legal/policy
complexity has stopped some electronic
health records (EHRs) from implementing
electronic reporting at all.”
Adam Greene agrees. An attorney
specializing in health information
privacy and security laws at Davis
Wright Tremaine, he says the complex
patchwork of rules along the e-highway
creates risk and expense for providers
and the public health system. “While
HIPAA permits providers to make public
health disclosures that are authorized or
required under law, a provider may not
have the resources to navigate exactly
what disclosures it can and cannot make.
Additionally, public health authorities
have to navigate state and local laws
governing their collection and disclosure
of information.”
6
LAB MATTERS Fall 2019
While HIPAA permits providers to make public health disclosures that
are authorized or required under law, a provider may not have the resources
to navigate exactly what disclosures it can and cannot make. Additionally,
public health authorities have to navigate state and local laws governing their
collection and disclosure of information.”
Adam Greene
Equalizing the Exchange of Data
On the one hand, we want privacy for
our personal health information. On the
other, we want protection from the next
epidemic through an informed public
health system. Like emergency vehicles
on our highways, health oversight
agencies protect the population. Will trust
in these agencies inspire allowances for
necessary rapid response?
Adding to the landscape are the various
“on-ramps” of exchange programs.
However, not all exchanges are equal
when it comes to functionality. “For
exchange programs that were created
primarily with treatment in mind, it’s
like designing an SUV, then trying to also
make it a sports car after you have begun
production,” says Greene. “It can be done,
but it’s not easy.”
The APHL Informatics Messaging Services
(AIMS) platform began in 2012 to handle
increasingly complex demands for
public health data. What used to take
days and weeks to share through mail,
fax, and data entry can now be done in
minutes. Tracking the opioid epidemic,
understanding flu’s mutations and
sharing best practices can be done in
near-real time.
PublicHealthLabs
@APHL
APHL.org