How HTI-2 Proposed Rule Aligns with Public Health Data Modernization

By Kim Boyd, Regulatory Resource Center Lead & Senior Consultant, Point-of-Care Partners
LinkedIn: Kim Boyd
LinkedIn: Point-of-Care Partners
Read Kim’s HTI-2 Series

Welcome back to our HTI-2 series! In our previous posts, we highlighted the general aspects of the HTI-2 proposed rule, delved into API certification requirements, explored the intricacies of information blocking, and examined the inclusion of requirements related to ePrescribing, Prior Authorization, & RTPB. Today, we’re focusing on how HTI-2 aims to support and strengthen public health and aligns closely with the data modernization efforts of the Centers for Disease Control and Prevention (CDC), creating a synergistic approach.

The COVID-19 pandemic exposed critical gaps in our public health infrastructure, particularly in data sharing and analysis. Outdated systems, fragmented data sources, and lack of standardization, similar to what is experienced in many other parts of healthcare, hindered real-time information sharing among healthcare providers and public health agencies. The CDC’s Data Modernization Initiative (DMI) addresses these issues by upgrading infrastructure, enhancing analytics, and streamlining data exchange. Aligned with the HTI-2 proposed rule, DMI’s intent is to ensure timely, accurate access to data and improved public health reporting, enhancing the ability to predict, respond to, and manage public health threats effectively.

HTI-2: A Solution to Support Public Health

HTI-2 introduces a comprehensive suite of technological advances and standards designed to address these challenges. HTI-2 emphasizes several key areas that directly impact public health:

1. Improved Data Exchange: One of the most critical aspects of HTI-2 is the focus on enhancing data exchange between healthcare providers and public health entities. The rule mandates the use of standards for accessing and exchanging healthcare information electronically, i.e.,Fast Healthcare Interoperability Resources (FHIR), and Application Programming Interfaces (APIs) to facilitate seamless data sharing. This ensures that public health agencies receive timely and comprehensive data, which is essential for effective surveillance and rapid response to emerging health threats.
2. Enhanced Interoperability: The HTI-2 rule places a strong emphasis on interoperability. By leveraging FHIR and APIs, the rule aims to create a more connected healthcare ecosystem where data can flow freely between healthcare providers, public health agencies, and other stakeholders. Such interoperability is crucial for real-time public health surveillance and enables more accurate tracking of health trends and potential outbreaks and aligns with other efforts to modernize the healthcare system.
3. Standardized and Streamlined Public Health Reporting: HTI-2 proposes the adoption of specific data standards and streamlined processes for public health reporting, addressing both the quality of data and the efficiency of reporting mechanisms. This comprehensive approach aims to improve data quality and consistency by adopting standardized formats, ensuring that healthcare providers report complete, accurate, and actionable information for public health decision-making. Simultaneously, it reduces the reporting burden on healthcare providers through simplified and standardized requirements. The integration of FHIR and APIs enables more automated and efficient data exchange, allowing public health agencies to receive timely and comprehensive data without placing additional strain on healthcare providers. This standardization also facilitates easier integration and analysis of data across different systems and agencies, significantly enhancing overall public health surveillance and response capabilities. By combining technical improvements with practical considerations, HTI-2 could be the catalyst to create a more efficient and effective public health reporting system that benefits both healthcare providers and public health agencies.

Specific Public Health Reporting Enhancements

HTI-2 proposes several specific enhancements to public health reporting, including:

• Laboratory Reporting: Improved standards for electronic laboratory reporting (ELR) to ensure that public health agencies receive timely and accurate lab test results, which are critical for monitoring and responding to infectious disease outbreaks.
• Cancer Registry Reporting: Enhanced data standards for cancer registry reporting to ensure comprehensive and accurate data collection on cancer incidence, vital for tracking trends and improving cancer prevention and control efforts across populations.
• Syndromic Surveillance: Standardization of syndromic surveillance data reporting to improve the early detection and monitoring of disease outbreaks based on symptom patterns.
• Immunization Reporting: Improved standards for immunization information systems to ensure accurate tracking of vaccination status and coverage, which is essential for managing immunization programs and responding to vaccine-preventable diseases.
• Case Reporting: Standardized electronic case reporting (eCR) to ensure that public health agencies receive timely and accurate information on reportable conditions directly from electronic health records (EHRs).
• Prescription Drug Monitoring Programs (PDMPs): Enhanced data sharing and interoperability standards (FHIR) for PDMPs to help monitor and prevent prescription drug abuse. This includes standardized reporting of controlled substances and improved access to PDMP data for healthcare providers to support better clinical decision-making.

The Importance of Investing in Public Health Technology

Recent global health events have underscored the critical role that robust public health monitoring plays in safeguarding our communities. These challenges have highlighted the need for a resilient, technologically advanced public health infrastructure capable of addressing a wide range of health threats. The investments outlined in HTI-2, supported by the CDC’s Data Modernization Initiative, are vital for building such an infrastructure. By leveraging cutting-edge technology to enhance data sharing, interoperability, and reporting, we can significantly improve our public health system’s capabilities. This technological upgrade enables faster detection of emerging health threats, more efficient tracking of chronic diseases, and improved response to environmental health hazards.

Investing in public health technology is not just about responding to crises; it’s about creating a proactive, data-driven approach to population health. With access to real-time, comprehensive data, public health officials can allocate resources more effectively, implement targeted interventions, and evaluate the impact of public health programs with greater accuracy. This investment will enhance our ability to predict and prevent health issues before they become widespread, ultimately leading to healthier communities and reduced healthcare costs. By ensuring our public health system is equipped with state-of-the-art technology and data capabilities, we can build a more responsive, resilient, and effective infrastructure that prepares us for both known and unforeseen public health challenges.

For more details, refer to the ONC HTI-2 Proposed Rule and the HHS Press Release. For more information on the CDC’s Data Modernization Initiative, visit CDC Data Modernization Initiative.

This article was originally published on the POCP blog and is republished here with permission.