The Digital Bridge Initiative: Improving Public Health Surveillance in the U.S.

Local health departments (LHDs) are the keystone to successful public health surveillance – the systematic and ongoing collection, management, analysis, and interpretation of data to stimulate public health action. As local providers of health services, LHDs are well-positioned to monitor community health data, flag potential public health threats, and intervene to prevent endemics, pandemics, and epidemics – but the data must be high quality. Presently, the landscape of methods of case reporting across local health jurisdictions varies significantly, from paper-based to electronic-based reporting from clinicians and hospitals. But the meaningful use of electronic health records (EHRs) in the United States presents opportunities to potentially improve public health surveillance and increase the quality and quantity of data reported to health departments.

The Digital Bridge initiative is a collaboration of the largest healthcare providers, EHR vendors, and public health practice associations in the U.S. The initiative’s vision is to improve the health of our nation by creating a bidirectional information exchange between health care and public health. Currently, Digital Bridge representatives and stakeholders are collaboratively developing an interoperable, multi-jurisdictional electronic case reporting (eCR) approach that will be available in the coming months.

Within the next year, the initiative is likely to define the essential operations of eCR from healthcare providers to public health. The Digital Bridge eCR effort will examine legal and policy issues to ensure patient privacy and data security. It will also examine strategies to sustain eCR infrastructure over time and support additional information-sharing opportunities that reduce costs and improve health. The resulting standard, robust reporting process will decrease the burden on reporters, providing public health agencies with more complete and timely information about diseases that threaten the public’s health. The process established by the Digital Bridge initiative may form the basis for getting other data to public health from EHRs, such as data about chronic disease.

While this effort will build on eCR work under development, it is also intended to identify a consistent, sustainable, and nationwide, approach to using health care’s EHR data to improve public health surveillance. Through more efficient data sharing, the Digital Bridge initiative will empower both public health and healthcare with the information needed to improve their constituents’ and patients’ health. Digital Bridge will capitalize on existing privacy and security technologies protecting patient data, while exploring how our nation’s health information infrastructure can become more connected. Greater connectedness among healthcare providers and public health practitioners will allow coordination that builds healthier communities.

Places interested in helping to establish and shape the process can now apply to be Digital Bridge Implementation Sites. In order to assure the process created by this initiative is robust across system variations within the US public health system, participation by a variety of sites is desired. Each site will need to include an organization which will send electronic initial case reports (eICR) to the AIMS platform (a secure, central distribution system) based on criteria from the Reportable Condition Knowledge Management System (RCKMS) and a public health agency (i.e., state or local health department) which will receive electronic reports from the AIMS platform.  More details and the application form are available at http://www.digitalbridge.us/implementationsites/. Sites will need to provide their own funding and resources. The deadline to apply is January 13, 2017.

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