Public health agencies (PHAs) play an essential role in the global health system, relying heavily on the exchange of accurate data to perform critical functions such as disease prevention and health promotion. However, these agencies face significant challenges, including outdated technology, fragmented data systems, and inconsistent funding, all of which limit their ability to modernise effectively. At the 2024 HIMSS Global Health Conference, key stakeholders discussed these issues, shared insights, and recommended strategies for driving forward public health data modernisation.
Building and Strengthening Partnerships
Strong partnerships between public health agencies, healthcare providers and IT suppliers are foundational to seamless data exchange. Such collaboration allows for better goal alignment and the reduction of duplicative efforts. Workshop participants emphasised that partnerships should include all relevant stakeholders, from local health departments to tribal organisations, to ensure comprehensive representation in strategic decision-making.
However, participants noted that communication breakdowns can slow the progress of partnerships. For instance, healthcare organisations may not always understand or prioritise public health data needs, creating gaps in the collaborative process. One example highlighted the challenges faced during the rapid expansion of electronic case reporting (eCR) when public health agencies were overwhelmed by an influx of data that did not always meet their needs.
To overcome these barriers, partners must prioritise clear and continuous communication, align on shared objectives and simplify processes such as onboarding. Including health information exchanges (HIEs) and health data utilities (HDUs) at regional and state levels in these discussions can further enhance coordination. Workshops and regular forums, such as the HIMSS24 event, play a vital role by fostering cross-sector connections and promoting best practices that strengthen partnerships.
Public Policy and Funding: Keys to Progress
Policy reforms and stable funding are critical for modernising public health data systems. Participants at the HIMSS24 workshop called for a harmonised approach to data-sharing policies, which would facilitate smoother cross-jurisdictional data exchanges. Establishing federal data-sharing standards and ensuring that IT products meet these requirements would aid in connecting disparate systems, ultimately improving data quality and utility.
Sustainable funding was identified as an equally important factor. The COVID-19 pandemic highlighted both the importance and the pitfalls of short-term, crisis-driven funding. While emergency funding allowed rapid responses during the pandemic, the reliance on such unpredictable resources poses a risk to the long-term sustainability of public health initiatives. HIMSS has estimated that $36.7 billion in funding is required over the next decade to support investments in data infrastructure and workforce development for the CDC and state, local, tribal and territorial (STLT) agencies.
Workshop participants recommended advocating for smaller, more frequent funding instalments that provide flexibility and stability for jurisdictions over time. This would help prevent the operational and human resource issues associated with spending larger sums within short timeframes. Additionally, participants highlighted the importance of investing in workforce recruitment, training and retention to ensure that PHAs maintain the expertise needed to leverage modern data systems effectively.
The Role of TEFCA in Public Health Data Exchange
The Trusted Exchange Framework and Common Agreement (TEFCA) was developed to create a standardised approach to data exchange, enhancing interoperability across healthcare and public health. TEFCA’s goals include establishing a universal framework for secure information exchange, simplifying connectivity and enabling individuals to access their health data. Workshop participants recognised TEFCA’s potential to facilitate public health reporting, emergency preparedness and statewide data exchanges.
Initial implementations of TEFCA, such as pilot projects involving eCR, revealed valuable use cases and highlighted potential challenges. These included complexities related to onboarding and ensuring data quality across different jurisdictions. For TEFCA to be fully integrated and effective, continuous education and technical assistance from bodies like the Office of the National Coordinator for Health Information Technology (ONC), the CDC and The Sequoia Project are essential. This support will help PHAs navigate the legal and regulatory landscape, especially as they prepare to engage in broader data exchanges.
TEFCA's flexibility to adapt to public health needs was also stressed. Public health entities must be prepared to manage change, integrating new processes that align with TEFCA’s capabilities while ensuring that TEFCA itself remains responsive to the unique requirements of public health operations. Participants suggested involving legal teams from the outset would help PHAs address potential regulatory issues effectively and facilitate smoother integration into TEFCA’s framework.
The modernisation of public health data systems is a multifaceted challenge that requires coordinated partnerships, supportive public policies and sustainable funding. The insights from the HIMSS24 workshop emphasised that fostering collaboration among public health, healthcare and IT suppliers is essential for overcoming barriers and enhancing data interoperability. Strategic investment in both technological advancements and workforce capacity is critical for building a resilient public health infrastructure that can respond swiftly and effectively to future challenges. Moving forward, consistent advocacy, shared best practices and adaptable frameworks like TEFCA will be central to achieving comprehensive public health data modernisation.
Source: HIMSS
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