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Meaningful Use of Electronic Health Records and Idaho Public Health

The Idaho Department of Health and Welfare (IDHW) Division of Public Health is working with providers, hospitals, and electronic health record (EHR) vendors to accept immunization data, electronic laboratory reports for reportable diseases and conditions, and emergency department syndromic surveillance data in a meaningful manner to improve public health. Public Health staff will work with vendors and hospitals after they have obtained certified EHRs to meet public health data reporting objectives. It is important providers select an EHR vendor that meets HL7 messaging standards and the federally mandated vocabulary standards for each data reporting category.

Vendors should obtain EHR certification using the Office of National Coordinator’s (ONC) process.

Certified EHR technology assures users that the EHR system or module offers the necessary technological capability, functionality, and security to meet Meaningful Use criteria. Certification also ensures that patient data may be shared with other systems confidentially. For more information about which EHR systems and modules are certified for the Medicare and Medicaid EHR Incentive Programs, visit The Office of the National Coordinator for Health Information Technology Certification Programs

Hospitals and providers can contact Public Health staff regarding meaningful use by emailing: PublicHealthMU@dhw.idaho.gov

Once providers, vendors, and hospitals contact Idaho public health staff, they will be guided on technical information and provided a way to exchange necessary documentation such as implementation guides. Upon agreement to send data, vendors, hospitals, and providers will send test data. The message will be validated by Idaho public health staff in a test environment. Once the message structure and content are deemed acceptable, data may proceed to production.

Electronic Laboratory Reporting

Electronic Laboratory Reporting (ELR) allows laboratories to report test results for reportable diseases through an automated and secure process to the statewide disease surveillance system. Laboratory data are sent in a standard HL7 2.5.1 format electronically through a secure interface. ELR allows for more rapid reporting to public health and reduces the facility’s reporting burden.

Note that laboratories are still required to immediately report by telephone positive test results for certain reportable diseases in addition to transmitting data via ELR. These diseases include: anthrax, botulism, diphtheria, tularemia, rabies in a human, and smallpox.

Immunization Data

Idaho’s immunization registry, the Immunization Reminder and Information System (IRIS), is a statewide population-based information system. The IRIS system currently has the following capabilities:

  • Accept immunization messages in HL7versions 2.3.1, 2.4, and 2.5.1.
  • Accept messages via secure email and secure FTP.
  • Real-time HL7 messages will be accepted via the SOAP transport layer soon. If your electronic medical record system in incapable of exporting an immunization file for email or FTP transmission, please contact the Idaho Immunization Program at (208) 334-5902 to discuss direct connection methods.

IRIS is a full-featured Immunization Information System which has capabilities beyond the simple storage and retrieval of immunization data. Medical providers enrolled in the Vaccines for Children (VFC) program in Idaho must manage their public vaccine inventory and complete their vaccine ordering and accountability activities through IRIS. IRIS also contains elaborate vaccine forecasting algorithms and reminder/recall functionality, both of which assist medical providers in keeping their patients up-to-date on their vaccinations. Registry users include medical providers (VFC and non-VFC), Public Health District staff, school personnel who work with health records, and licensed child care facilities.

Idaho law (39-4803 Idaho Code) does not permit bi-directional data exchange between IRIS and EHRs; IRIS is only capable of receiving data from other systems, and does not send immunization data back to those systems.

Syndromic Surveillance Data

Syndromic surveillance uses near real-time patient data and statistical tools to enable the timely assessment of community data. The usefulness of syndromic surveillance is not limited to early event detection, but can aid public health in tracking the health of communities, maintain situational awareness during outbreaks, more closely monitor seasonal increases or decreases of known illnesses, and identify health effects of events such as poor air quality. Eligible hospitals can meet Meaningful Use requirements for syndromic surveillance data submission by submitting emergency department (ED) data to the BioSense 2.0 system. Data are sent in an encrypted HL7 message to an Idaho-specific site within the BioSense 2.0 web-based application for aggregated analyses.

Cancer Registry

The Cancer Data Registry of Idaho (CDRI) is a statewide population-based cancer registry, authorized by Idaho Code 57-1703 through 57-1707, that collects incidence and survival data on all cancer patients who reside in the state of Idaho or who are diagnosed and/or treated for cancer in the state of Idaho.

CDRI plans to accept cancer registry reporting for Meaningful Use Stage 2 as a menu objective for Eligible Professionals (EP).  Transport methods include PHIN-MS (Public Health Information Network Messaging System), Web Plus, and CDRI's secure file portal. All methods use a secure messaging platform that can provide a common approach to security requirements such as data encryption and authentication. The Stage 2, meaningful use objective and measure for cancer registries are:

  • Objective: Capability to identify and report cancer cases to a public health central cancer registry, except where prohibited, and in accordance with applicable law and practice.
  • Measure: Successful ongoing submission of cancer case information from certified electronic health record technology (CEHRT) to a public health central cancer registry for the entire EHR reporting period.

Resources

  • Implementation Guide for Healthcare Provider Reporting to Central Cancer Registries, August 2012

    This document provides clear and concise specifications for electronic reporting from ambulatory healthcare provider EHR systems to public health central cancer registries using Health Level Seven (HL7) Clinical Document Architecture (CDA) based standards. This document is designed to guide EHR vendors and public health central cancer registries in the implementation of standardized electronic reporting. It includes both business rules and standardized specifications.