Shaun Grannis MD MS FAAFP The Regenstrief Institute, Inc. Indiana University School of Medicine

1. Connecting Public Health to Clinical Care through Health Information Exchange:Current Activities in Indiana Shaun Grannis MD MS FAAFP The Regenstrief Institute, Inc. Indiana University School of Medicine

2. What We’ll Cover • Brief overview of the Indiana health information exchange and public health environment • Data flows/coverage • Notifiable condition detection • Clinical messaging • Targeted public health alerting • Enhancing clinician reporting to public health • Surveillance

3. The Problem(s) • Data needed for public health processes, including situational awareness processes, are scattered across separate systems • This situation hinders public health's ability to perform situational awareness • HIE's can aggregate and deliver data to support public health practice

4. The Problem(s) • Public health generally lacks methods for communicating with clinical enterprise that are at once efficient, reliable, consistent, and comprehensive • This situation hinders bi-directional communication capabilities between PH and clinical care • HIE's can facilitate bi-directional communication

5. Information Exchange

7. Automated Notifiable Case Detection

8. Notifiable Condition Detector E-mail Summary Abnormal flag, Organism name in Dwyer II, Value above threshold Realtime Compare to Dwyer I Daily Batch To Public Health Reportable Conditions Databases Inbound Message Potentially Reportable Reportable Condition To Infection Control Record Count as denominator Print Reports

9. NCD Login Screen

10. NCD Administration Page

11. NCD Dashboard Page

12. Clinical Messaging/Public Health Messaging

13. Results Delivery – An Illustration

14. Targeted Public Health Alerting

19. Enhancing clinician reporting to public health

20. Reporting Form

21. Conclusions • Success Factors • Add value (solve problems) • Proceed Incrementally • Re-use existing processes • Key Questions • What’s the problem? • What solution? • How does solution address the problem?

22. Surveillance

23. Chief complaint (ADT): • Clinical abstract trigger • Medication reconciliation trigger • Hospital utilization tracking • ICD-9: • Clinical Care (EMR) • Clinical DSS • Quality Reporting • Lab tests: • Results delivery • Clinical care (EMR) • Notifiable condition detection • Public Health processes

24. Connecting Public Health to Clinical Care through Health Information Exchange:Current Activities in Indiana Shaun Grannis MD MS FAAFP The Regenstrief Institute, Inc. Indiana University School of Medicine