HIMSS23, held in Chicago April 17-21, 2023, was attended by more than 35,000 from around the world. Similar to past years, it centered around a trade show exhibit hall, interoperability showcases and educational sessions. Two members of the HLN Consulting team, Aasa Dahlberg Schmit and Mike Berry, attended.
Mike Berry presented “Sharing Bulk Immunization Data Using HL7 V2 and FHIR,” with Jeffrey Goggin and Stuart Weinberg. The educational session summarized the current landscape of bulk data exchange in the immunization community, compared alternative approaches to sharing immunization data in bulk, and described how the HL7 Helios FHIR Accelerator for Public Health is advancing the FHIR-based exchange of bulk IIS data. HLN’s work with the Rhode Island Department of Health was featured to demonstrate a real-world example of FHIR in Immunization Information Systems (IIS).
A key focus for the HLN team was the interoperability showcase, where multiple use cases for public health were demonstrated, including:
Moving the needle: Sharing Immunization Records, Demonstrated how interoperability standards are used to provide individuals with access to their current COVID vaccination status, independent of where the vaccination was received and where the patient currently resides. The use case showed how the initial vaccination at a Veterans Health Administration (VHA) clinic is shared with the public health Immunization Information System (IIS) via the Immunization Gateway (IZ Gateway), and how the systems work together to send notifications to the individual to receive second and subsequent vaccination doses, even when the patient is residing in his second residence in another state. All of these vaccinations are available through consumer access tools, and both state registries have a complete record of their vaccine history. Finally, the public health agency is able to offer the individual a SMART Health Card with can be shared with providers and show as proof of vaccination when needed
Safely caring for those in need, Showed how interoperability between clinical systems and public health systems provides care coordination for a patient with Type II diabetes exposed to active tuberculosis (TB) at work. The TB diagnosis triggers an Electronic Case Report (eCR) to be sent to the AIMS platform and then to the appropriate public health jurisdiction once the Reportable Conditions Knowledge Management System (RCKMS) determines reportability. The public health agency investigates the conditions and recommends improving worker protection. The patient has no symptoms of TB, but the blood work performed prior to starting therapy to clear the infection reveals that the patient may also now have chronic kidney disease (CKD). This finding automatically triggers an alert, and data exchange with the patient’s primary care provider, who refers her to a nephrologist for follow-up. The nephrologist confirms the diagnosis as early-stage CKD and begins a monitoring program to help manage diabetes to slow the CKD progression.
Connecting the whole person to public health reporting, demonstrated how a multidisciplinary team works through interoperable systems to provide a patient diagnosed with cancer with an optimal treatment plan and integrated care as well as reporting to the public health jurisdictional cancer registry, which includes the data in the analysis of the link between cancer and work. When the patient is in a fatal car accident the use of FHIR-based interoperability between medical examiner and coroner systems, state and national vital records, and state cancer registry contribute to the timely reporting of mortality information.
Connecting with patients at home, showed the use of interoperability with wearables and devices such as health trackers and pulse oximeters to better connect with their health system and public health. The demonstration showed how information in interoperable equipment at home together with the ability to order and take tests at home, with subsequent reporting of test results to health care providers and public health, is used to early dispatch EMTs to a patients house to obtain prophylaxis instead of an urgent visit to the ED.
Overall the interoperability showcase provided good examples of how Interoperable systems provide more complete, timely, and improved quality data for monitoring the burden of disease, and provides opportunities for better and more timely care. HLN is involved in many of the standards, technologies, and systems that were featured in the showcase, including IIS, Clinical Decision Support for Immunization and ICE, Immunization Gateway, and RCKMS.
Other public health informatics related topics presented during the conference touched on how CDC’s Data Modernization Initiative (DMI) plans to modernize public health data and information systems to meet the evolving needs of the community; how to standardize quality, research and public health data within HHS using the U.S Core Data for Interoperability (USCDI) as a foundation; and MedMorph, a reference architecture that is part of CDC’s DMI efforts and is intended to facilitate rapid, reliable and adaptable EHR data exchange.
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