Improved interoperability is key to managing COVID-19 spread
A research team from the Duke-Margolis Center for Health Policy outlined a three-part strategy to improve data interoperability and exchange to support COVID-19 containment, with a focus on utilizing and enhancing existing infrastructure to speed implementation.
In order for public health authorities, healthcare providers, laboratories, and community-based organizations to more effectively collaborate, the report authors recommend improvements in commercial-lab reporting; better access to clinical data through a dedicated, secure portal; and enhanced use of the National Syndromic Surveillance Program.
The report also calls for using existing systems rather than building new systems and keeps the focus on solutions that can be designed and implemented within the next 30 to 90 days, and stresses "immediate needs call for immediate solutions."
In the area of lab reporting, the report noted up to half of lab reports submitted to public health can lack a patient address or zip code, often key demographic data elements used in identifying infection clusters and localizing disease hotspots.
This information is also vital to contacting cases in order to complete investigations and match patient information. The report recommends that standard reporting should include commercial laboratories, point-of-care testing manufacturers and test implementers.
Better access to clinical data, meanwhile, can be improved using the existing major trust frameworks employed by the majority of hospitals and health systems: The CommonWell Health Alliance (which includes Cerner, Meditech, and CPSI participants) and Carequality, which includes Epic, among others.
In order to provide the necessary security and privacy surrounding these data queries, the report recommends health officials assert existing legal authority and minimum data necessary as a routine part of onboarding into the data exchanges.
The research authors pointed to the Patient Unified Lookup System for Emergencies and Health Gorilla as two intermediaries that could likely offer sufficient "on ramps" for healthcare providers and other actors to access the exchanges.
Concerning enhanced use of the NSSP, the report notes Federal/State collaboration will be a critical component to any successful alignment of data-sharing protocols and permitted use specifications, while lack of metadata standards and slowing reporting times were seen as additional challenges.
"The success of COVID-19 containment as the United States reopens will depend on timely sharing of key information related to testing, contact tracing, and detecting and acting on new outbreaks," the report's authors said.
The pandemic has highlighted the need for patient access and API-enabled exchange in a situation that calls out for wider, more comprehensive and expeditious sharing of information for public health reporting.
However, data interoperability remains a major hurdle in the healthcare industry, which has led tech giants like Google to develop its Cloud Healthcare API, which is focused on helping providers comply with CMS and ONC data exchange regulations during the pandemic and beyond.