The Idaho Department of Health and Welfare (IDHW) Division of Public Health has declared readiness as of June 2019 and is actively working with providers, hospitals, and electronic health record (EHR) vendors to accept immunization data, electronic laboratory reports for reportable diseases and conditions, electronic case reports, and 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.
Providers can contact Division of Public Health staff regarding Promoting Interoperability (formerly Meaningful Use) by emailing: PublicHealthMU@dhw.idaho.gov
Once providers and vendors contact Idaho public health staff, they will be guided on technical information and provided a process 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 in a test environment. Once the message structure and content are deemed acceptable, data may proceed to production.
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.
Electronic case reporting allows eligible providers and hospitals to report clinical and patient data for reportable diseases through an automated and secure process to the statewide disease surveillance system. Electronic case reports are sent following the HL7 CDA® R2 Implementation Guide: Public Health Case Report Release 2 – US Realm – the Electronic Initial Case Report (eICR) electronically through a secure interface. ECR allows for more rapid reporting to public health and reduces the burden of provider and facility reporting via paper or phone.
Note that providers and hospitals are still required to immediately report by telephone positive test results for certain reportable diseases in addition to transmitting data via ECR. These diseases include: anthrax, botulism, diphtheria, tularemia, rabies in a human, and smallpox.
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:
- IRIS has batch capabilities to accept HL7 version 2.4 and HL7 version 2.5.1
- IRIS has real-time capabilities to accept HL7 version 2.4 and HL7 version 2.5.1 through a SOAP webservice
IRIS is a fully operational Immunization Information System with capabilities beyond simple storage and retrieval of immunization data. Medical providers enrolled in the Vaccines for Children (VFC) program in Idaho must manage their Idaho Immunization Program-supplied vaccine inventory and complete their vaccine ordering and accountability activities through IRIS. IRIS maintains a clinical decision support (CDS) utility function (forecaster). The business rules for the CDS schedules can be updated to reflect any new or revised recommendations from the Advisory Committee on Immunization Practices. In addition, IRIS has 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 childcare facilities.
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 and Providers can meet promoting Interoperability requirements for syndromic surveillance data submission by submitting Visit Data to the BioSense system. Data are sent in an encrypted HL7 message to an Idaho-specific site within the BioSense web-based application for aggregated analyses.
Syndromic Surveillance Resources:
Onboarding Process - Email PublicHealthMU@dhw.idaho.gov
Idaho BioSense Syndromic Surveillance Implementation Guide - This document covers the requested data elements and message format required for data submission to BioSense.
BioSense Platform Individual Patient Record-Level Data Elements Accessible at National and HHS Regional Levels - This document lists the record-level data elements submitted to the BioSense Platform that will be automatically available at the Health and Human Services Region X level and the national level
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 live 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 Promoting Interoperability as a menu objective for eligible professionals. 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.
Cancer Registry Resources: https://www.idcancer.org/
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.
Certified EHR technology assures users that the EHR system or module offers the necessary technological capability, functionality, and security to meet Promoting Interoperability 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.