The world of health IT standards can often feel removed from the daily realities of public health. But increasingly, those worlds are colliding, and for fine reason. As someone who’s spent the last several years deeply involved in the implementation of standards supporting public health initiatives, I’ve witnessed firsthand the critical need to bridge the gap between the sophisticated health information ecosystem built for patient care and the urgent demands of public health agencies. This shift in focus, spurred in part by the challenges exposed during the COVID-19 pandemic, is driving significant innovation and collaboration within the HL7 community and beyond.
The core of this effort lies in modernizing public health data infrastructure. For decades, many agencies have relied on legacy systems – often dating back decades – that struggle to handle the complexity, volume, and interoperability requirements of modern healthcare data. This reliance hinders their ability to respond effectively to public health emergencies, analyze population health trends, and address health inequities. The transition from older standards like HL7 V2 and CDA to FHIR (Fast Healthcare Interoperability Resources) is therefore paramount. FHIR, with its web-based APIs and flexible architecture, offers a more adaptable and efficient solution for data exchange, particularly in a rapidly evolving healthcare landscape. This modernization isn’t simply a technical upgrade; it’s about empowering public health professionals with the tools they need to protect communities.
Connecting Public Health to the Health Information Superhighway
A key component of this modernization is enabling public health agencies to connect to the broader health information ecosystem through initiatives like TEFCA (Trusted Exchange Framework and Common Agreement) and national networks. TEFCA, established by the Office of the National Coordinator for Health Information Technology (ONC), aims to create a universal floor for interoperability across the country, allowing for seamless and secure data exchange. The ONC’s website provides detailed information about TEFCA’s goals and implementation. By leveraging these networks, public health agencies can access critical data more easily, quickly, and affordably, improving their ability to monitor disease outbreaks, allocate resources effectively, and coordinate responses during public health crises.
Over the past few years, I’ve had the privilege of working alongside a dedicated team developing tools to facilitate this connection. At two recent FHIR Connectathons – collaborative testing events where developers come together to validate and refine FHIR implementations – I collaborated with this team to build “on-ramps” for public health agencies. These on-ramps, built on the foundation of FHIR standards, aim to provide agencies with better access to their own data and enable them to participate more fully in the national health information exchange. Through this work, I’ve been able to contribute to achieving a five-year goal I set for myself in early 2021: to improve the flow of critical data to public health organizations.
Recognizing Leadership: Daniel Paseltiner of Skylight
Innovation in health IT rarely happens in isolation. It requires leadership, collaboration, and a willingness to empower others. That’s why I want to highlight the contributions of Daniel Paseltiner, of Skylight. While our paths don’t frequently intersect directly, his leadership has been instrumental in enabling my work and, in advancing the cause of public health data modernization. He embodies the spirit of collaborative problem-solving that is essential to driving meaningful change in healthcare.
Daniel’s team at Skylight has been developing tools to help public health agencies connect to the health information superhighway. Their work on the DIBBS Query Connector project on GitHub, a project in collaboration with the Centers for Disease Control and Prevention (CDC), is a prime example of this commitment. The DIBBS Query Connector facilitates data exchange between public health agencies and the broader healthcare ecosystem, enabling more informed decision-making and more effective public health interventions. The CDC’s involvement underscores the importance of this work to the nation’s public health infrastructure.
Good leaders, as Daniel demonstrates, focus on enabling the success of others. In my case, his work created opportunities for me to contribute to a goal I’d been pursuing for years. It’s a testament to the power of collaboration and the importance of recognizing those who quietly facilitate progress.
The SANER Project: A Foundation for Collaboration
The efforts to connect public health and the broader health information ecosystem are rooted in initiatives like the SANER (Situational Awareness for Novel Epidemic Response) Project. According to a blog post from HL7, the project was launched in response to the COVID-19 pandemic, aiming to automate the transmission of critical resource data – such as ICU bed availability and ventilator counts – to emergency response authorities. The project leverages HL7 FHIR standards to enable real-time data exchange between healthcare organizations and public health agencies. Audacious Inquiry played a key role in developing the initial FHIR Implementation Guide for SANER, contributing existing content to HL7 and collaborating closely with the organization to accelerate the project’s development. Scott Afzal, President of Audacious Inquiry, highlighted HL7’s rapid response in supporting the effort, noting that the Implementation Guide was developed within just two weeks of the project’s launch.
The Future of Public Health Data Exchange
The challenges facing public health data infrastructure are significant, but the momentum towards modernization is undeniable. The adoption of FHIR, coupled with initiatives like TEFCA and projects like SANER and the DIBBS Query Connector, is paving the way for a more connected, efficient, and resilient public health system. As Keith Boone, Standards Guru and Enterprise Architect at Audacious Inquiry, wrote in Healthcare IT Today, the transition to FHIR is superior to legacy systems like HL7 V2 in multiple ways, offering standardized APIs, easier integration with modern applications, and greater flexibility. Continued investment in these technologies and collaborative efforts will be crucial to ensuring that public health agencies are equipped to meet the challenges of the future.
The work being done now isn’t just about improving data exchange; it’s about saving lives and protecting communities. It’s about ensuring that public health professionals have the information they need to make informed decisions, allocate resources effectively, and respond swiftly to emerging threats. It’s a complex undertaking, but one that is essential to building a healthier and more resilient future.
Looking ahead, the HL7 community will continue to refine and expand these standards, working closely with public health agencies and industry partners to address evolving needs. The next major milestone will be the continued rollout of TEFCA across the nation, with ongoing efforts to ensure seamless interoperability and data exchange. Further development of FHIR Implementation Guides tailored to specific public health leverage cases will also be critical. The ongoing FHIR Connectathons will remain a vital forum for testing and validating these implementations, fostering collaboration and driving innovation.
Key Takeaways:
- The modernization of public health data infrastructure is crucial for effective emergency response and population health management.
- FHIR is emerging as the standard for health data exchange, offering significant advantages over legacy systems.
- Initiatives like TEFCA and SANER are driving progress towards a more connected and interoperable public health ecosystem.
- Collaboration between HL7, public health agencies, and industry partners is essential for success.
I encourage you to learn more about these initiatives and the ongoing efforts to improve public health data exchange. Share your thoughts and experiences in the comments below. Let’s continue the conversation and work together to build a healthier future for all.