Lab Matters Fall Winter 2021 | Page 25

INFORMATICS

by Rachel Shepherd , specialist , Informatics

APHL ’ s Informatics Messaging Services ( AIMS ) has long been a trusted and secure place for public health to exchange data . Building on that legacy , APHL became a Health Information Service Provider ( HISP ) in August 2021 , enhancing AIMS ’ s capacity to seamlessly connect to a larger community of providers . A HISP is an accredited network service operator that enables nationwide clinical data exchange using direct secure messaging .

This accreditation establishes AIMS as part of a federally recognized and trusted network of data senders and streamlines the process of secure data exchange between partners . This network of more than 268,000 organizations — electronic health record ( EHR ) vendors , healthcare organizations , medical providers and hospitals — collectively exchanges more than 326 million messages per quarter . As part of this group , AIMS has the capability to connect with all other members . In other words , if a laboratory using AIMS needs to connect to a hospital that is part of this network , much of the preliminary work for establishing a direct connection is already done .

While the laboratory and hospital would still have to engage in the onboarding process , the effort is significantly reduced . By being part of this network , AIMS has already proven its ability to establish technical connectivity and its affiliated processes have all been vetted . The laboratory and provider can connect much faster without that need to establish technical connectivity and without the time ordinarily required to troubleshoot any issues that might otherwise arise during that process . Additionally , in many cases these laboratories may not have the time , necessary personnel , funding or other resources to individually develop connections with each provider or partner .

Another way that HISP can offer significant time savings is by reducing the legal burden . By exchanging information via AIMS within this trusted framework , all participating organizations ensure the use of the same agreements , requirements and standards . This allows entities to potentially forego individual legal review of peer-to-peer contracts to establish a new connection . This is often referred to as “ scalable trust ” because each new connection between organizations and their users and clients grows the network .

Developing the technical connection and the necessary legal framework between a laboratory and a provider can take a significant amount of time — potentially requiring many months of effort — so being able to connect quickly through APHL ’ s HISP instead is a tremendous benefit to the public health community .

Becoming a HISP

Becoming an accredited member of this trusted network is a rigorous process that involves the review and evaluation of security protocols for transporting data , legal compliance , incident response processes , access management and more . The accreditation is granted by DirectTrust , a nonprofit membership organization and ANSI-accredited standards body charged with validating reliable and trusted exchanges and provisioning access to organizations that meet its criteria . DirectTrust audited APHL , vetting its systems , infrastructure , processes and documentation to ensure the highest levels of security . While the audit itself lasted only three days , it took six months of preparation .

Use Cases

APHL ’ s HISP going live comes at a crucial moment . As laboratories look to expand their electronic data exchange capabilities with medical providers , as required under the US Centers for Disease Control and Prevention ’ s Data Modernization Initiative , having access via AIMS to this trusted network will make connectivity with many partners much more easily achievable .

HISP will be especially beneficial for use cases such as electronic case reporting ( eCR ), or for the exchange of electronic test orders and results . eCR is the automated , real-time exchange of case report information between EHR vendors and public health agencies for reportable diseases . Since there are dozens of diseases and conditions that are required to be reported , the ability for public health departments to receive that information electronically quickly enables surveillance for communicable diseases . Similarly , when providers electronically send test orders to laboratories and receive the result back electronically , they can act upon that information much faster , resulting in better patient care .

It is fitting for all of public health — laboratories , agencies , medical providers and the communities they serve — to communicate electronically . With the advent of APHL ’ s HISP , public health is in a better position to do just that . n