Public Health Agencies Look to Meaningful Use Program to Improve Disease Reporting

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By Alex Ruoff  

March 25 --Public health agency representatives told Bloomberg BNA March 24 they're looking to the meaningful use program to open up electronic pipelines of health data between doctors' electronic health records and public health data registries.

The meaningful use program promises to bring more reliable, “fresher” health data to public health agencies through automatic reporting of data from EHRs to public disease registries and immunization records, Paul E. Jarris, executive director of the Association of State and Territorial Health Officials (ASTHO), told Bloomberg BNA.

“We have this tremendous opportunity with electronic records to improve the reporting of diseases and our knowledge of population health,” Jarris said.

State public health and Medicaid agencies have spent more than $300 million readying their health record and disease management systems to accept data from providers' electronic health records.  

Working with the Centers for Disease Control and Prevention and the Department of Health and Human Services, state public health and Medicaid agencies have spent more than $300 million since 2011 upgrading their health record and disease management systems to be capable of accepting electronic health data from the more than 450,000 health-care providers and 5,011 hospitals eligible to participate in the meaningful use program.

However, providers and hospitals have been slow to adopt the public health reporting measures in Stage 1 of the meaningful use program and health information technology vendors have lobbied to remove expanded public health requirements from Stages 2 and 3 of the program.

Public Health Preparation

The Health IT Policy Committee--the main advisory body for the Office of the National Coordinator for Health IT--March 11 removed a recommendation for requiring the reporting of syndromic surveillance data to public health agencies in Stage 3, and debated removing several other public health requirements (see previous article).

Two public health agency groups, ASTHO and the Joint Public Health Informatics Taskforce (JPHIT), sent letters to the Health IT Policy Committee in favor of the public health reporting measures.

“We don't want to miss the opportunity that the meaningful use program presents,” Paula Soper, senior director for public health informatics at ASTHO, told Bloomberg BNA. “Public health has been waiting with bated breath for the promise of electronic records.”

Public health agencies have made great strides to have their electronic laboratory reporting, immunization information and syndromic surveillance systems ready to receive data from providers and hospitals, Soper said.

Nearly 80 percent of public health agencies were capable of receiving electronic laboratory reports and immunization records in 2011, when the meaningful use program began, according to a 2011 ASTHO survey. In 2013, Soper said, more than 90 percent of public health agencies were able to receive electronic laboratory reports and 85 percent were ready to receive immunization data.

Provider Participation

While public health agencies have raced to upgrade their systems to be capable of receiving electronic public health data, hospitals and providers have been slow to report the data, according to Centers for Medicare & Medicaid Services data.

As of December 2013, fewer than 20 percent of hospitals and fewer than 10 percent of providers participating in the meaningful use program chose to report syndromic surveillance data. Syndromic surveillance reporting had the fourth-highest rate of deferral of any meaningful use objective, with 69 percent of providers deferring the objective.

To meet Stage 1 incentive requirements, providers and hospitals can pick which objectives they want to meet and which to defer, as long as they meet a certain total number of objectives.

Immunization registries have had the highest performance rate of any public health objective in the meaningful use program, with nearly 60 percent of hospitals and 37 percent of providers meeting the measure, according to CMS data.

Vendor Response

Electronic health record vendors say that the increasing complexity of the meaningful use program will cause electronic health records to become too difficult for providers to use effectively.

Health IT vendors are not specifically against public health reporting requirements for the meaningful use program, Leigh Burchell, vice chairwoman for the Electronic Health Record Association, told Bloomberg BNA, but are pushing for a broad reductions in the number of requirements in Stage 3 of the meaningful use program.

“The meaningful use program is not having a positive effect on EHR usability,” she said. “Developers are focusing only on making EHRs that meet meaningful use requirements, not helping doctors perform better, because there are so many requirements to meet.”

Burchell said policy makers should make the meaningful use program less prescriptive to allow EHR vendors to focus on improving the design of their products. She said providers are having to spend more and more time interacting with their EHRs and less with patients, potentially hindering their ability to deliver health-care services.

To contact the reporter on this story: Alex Ruoff in Washington at

To contact the editor responsible for this story: Kendra Casey Plank at

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