Lab Matters Fall 2019 | 页面 8

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