DATA AT THE SPEED
OF HEALTH
In Utah, the state department of health is using the APHL Information Messaging System (AIMS) to automate reporting of pertussis, Zika virus and other diseases, so health authorities can arrest their spread.
DATA AT THE SPEED
Data at the Speed of Health
During just two months in early 2019, Utah’s largest medical system, Intermountain Healthcare, sent about 18,000 initial electronic case reports for five priority illnesses to the state health department: pertussis, Zika virus, salmonellosis, chlamydia and gonorrhea. Patient data for these “notifiable diseases”—just five of the 70 or so conditions whose reporting is required by Utah law—flowed through AIMS, APHL’s secure, cloud-based platform that will eventually replace all paper reporting for Intermountain providers. (All of the conditions that are reportable to national health authorities will be in production by June 2020.)
Jason Barnes, a senior health informaticist at the Utah Department of Health, is at the receiving end of that electronic data. He said, “We want to let providers spend as much time as possible taking care of their patients. But they also have a public health responsibility to report certain communicable diseases to make sure those diseases don’t spread throughout Utah. To prevent the spread of disease, we need to know what diseases are out there in the population.”
To prevent the spread of disease, we need to know what diseases are out there in the population.
Data at the Speed of Health
During just two months in early 2019, Utah’s largest medical system, Intermountain Healthcare, sent about 18,000 initial electronic case reports for five priority illnesses to the state health department: pertussis, Zika virus, salmonellosis, chlamydia and gonorrhea. Patient data for these “notifiable diseases”—just five of the 70 or so conditions whose reporting is required by Utah law—flowed through AIMS, APHL’s secure, cloud-based platform that will eventually replace all paper reporting for Intermountain providers. (All of the conditions that are reportable to national health authorities will be in production by June 2020.)
Jason Barnes, a senior health informaticist at the Utah Department of Health, is at the receiving end of that electronic data. He said, “We want to let providers spend as much time as possible taking care of their patients. But they also have a public health responsibility to report certain communicable diseases to make sure those diseases don’t spread throughout Utah. To prevent the spread of disease, we need to know what diseases are out there in the population.”
To prevent the spread of disease, we need to know what diseases are out there in the population.
The AIMS solution—now in production in seven jurisdictions for select conditions under the collaborative Digital Bridge initiative and over a dozen jurisdictions outside that effort—uses data from electronic health records and applies set rules (which vary from jurisdiction to jurisdiction) to determine whether or not individual disease cases are reportable to health authorities. Using special software hosted on AIMS—the Reportable Conditions Knowledge Management System or RCKMS—health department informatics staff can set up, test and validate the reporting rules for their own state or locality and then update them at any time.
Having APHL facilitate … has been a big help for us. APHL carries a lot of weight.
The AIMS solution—now in production in seven jurisdictions for select conditions under the collaborative Digital Bridge initiative and over a dozen jurisdictions outside that effort—uses data from electronic health records and applies set rules (which vary from jurisdiction to jurisdiction) to determine whether or not individual disease cases are reportable to health authorities. Using special software hosted on AIMS—the Reportable Conditions Knowledge Management System or RCKMS—health department informatics staff can set up, test and validate the reporting rules for their own state or locality and then update them at any time.
If a patient seeks healthcare in Utah, but resides in another state using AIMS for notifiable disease reporting, AIMS can also report to the patient’s home state, if RCKMS determines that the case meets that state’s reporting criteria.
“It relieves the burden on the providers to have to keep track of all the rules,” said Barnes. “RCKMS does the decision-making.”
The AIMS platform itself is infinitely scalable and fully compliant with the Health Insurance Portability and Accountability Act and Federal Information Security Modernization Act.
In addition to maintaining AIMS, APHL secures the legal agreements necessary to assure health agencies have legal access to notifiable disease data uploaded to AIMS. All of these activities support the Digital Bridge vision to “ensure our nation’s health through a bidirectional information flow between health care and public health.”
In Utah, Barnes’s team is now setting up reporting rules for hepatitis C and looking to entice additional large hospital groups to upgrade to the AIMS reporting system. “Having APHL facilitate the conversion among electronic health record vendors, hospitals and the health agency has been a big help for us,” he said. “APHL carries a lot of weight.”
Ultimately, the AIMS solution saves time for doctors and nurses, while providing more timely, complete and accurate data to inform public health activities such as foodborne disease investigations for salmonellosis or contact tracing for gonorrhea. It enables public health epidemiologists to spend more of their time investigating outbreaks and less time chasing down missing case information. The goal? To make data flow faster than diseases can spread.
Banner: The UDOH eICR/ELR Informatics team. Photo: UDOH
Top Left: A snippet from a demonstration electronic initial case report (eICR) message containing demographic information for a patient. Photo: UDOH
