In February 2022 the Sequoia Project released its Emergency Preparedness Information Workgroup’s Pandemic Response Insights and Recommendations. This workgroup was convened in the fall of 2020 at the height of the pandemic with a diverse set of stakeholders from all areas of the healthcare system. The resulting short report is worth a read as it offers concise analysis and recommendations.
The first task the workgroup undertook was to conduct a SWOT (strengths, weaknesses, opportunities, threats) analysis focused on pandemic response. There was a strong public health focus that resulted from this activity: “During a declared emergency, and during non-emergency times as well, public health should be viewed as a collaborator and partner with equal access to shared data” (p. 6). There was also a strong recognition that workforce capability has a lot to do with pandemic preparedness, as does the connection between what goes on at the local level and the national planning strategy.
The report then provides sixteen succinct recommendations:
- Reconcile Big Ideas with Realism
- Build on Existing Infrastructure
- Leverage the Lessons of Other States
- Address Policy Confusion
- Understand Funding Opportunities
- Develop Funding Sustainability and Matching
- Identify State and Local Emergency Response Workforce Resources and Capabilities
- Ease Legislative Policy and Regulatory Constraints for Data Sharing
- Address Public Health and Emergency Response IT Infrastructure
- Support Healthcare Equity
- Assess Public Health Emergency Response Technology Tools
- Share Vaccination Records Bi-Directionally
- Support Vaccination Equity
- Evaluate Data Analytics Capabilities
- Stop Duplicative Efforts
- Expand Access to Prescription Monitoring Program Data
With our focus in public health information technology, I was drawn to a few of these recommendations in particular. “Address Public Health and Emergency Response IT Infrastructure” is being largely addressed through CDC’s Data Modernization Initiative (DMI) as well as targeted Congressional funding for public health systems including Immunization Information Systems (IIS) and electronic case reporting (eCR). “Assess Public Health Emergency Response Technology Tools” will likely happen in that DMI context, but additional information needs to be made available to potential information technology procurers to assist in making good purchase decisions. Open source technologies should also play a major part in the solution landscape and there has been very little attention given to this in public health to date.
I was puzzled a bit by “Share Vaccination Records Bi-Directionally.” Most IIS do in fact support data query by clinical providers, and an increasing number are enabling various forms of direct consumer access through portals and mobile apps including the issuance of vaccine credentials. As for the suggestion that HL7 v2 Admission, Discharge, and Transfer (ADT) messaging might somehow be useful when query is not available, this is not something that IIS are capable of supporting at this time. If anything, the future focus for IIS and data access will shift to HL7 Fast Healthcare Interoperability Resources (FHIR), but even that is some time off.
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