Cloud computing could help lift public health
To reap the rewards of both new data sources created by meaningful use regulations, and new integrated systems that offer greater capabilities, public health systems must revamp their IT capabilities, according to an article published in the March edition of the American Journal of Public Health.
“In light of the absence of new resources to fund public health IT and the economies of scale created by cloud computing, practitioners should choose to move collectively to a new model of shared infrastructure that can keep pace with the evolution of the healthcare system's IT; otherwise it will become more isolated from and less relevant to the clinical care system,” wrote Leslie A. Lenert, MD, and David N. Sundwall, MD, both from the University of Utah, Salt Lake City.
The HITECH Act is intended to enhance reimbursement of healthcare providers for meaningful use of EHRs. This presents both opportunities and challenges for public health departments.
To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health’s IT systems largely lack the capabilities to accept the types of data proposed for exchange.
“The HITECH Act could increase availability of data from the clinical care system to public health, but the needs for expansion of the capabilities [of] public health IT systems are great and the funding to meet these needs is relatively small,” the authors wrote. “Allowing the healthcare system to evolve without public health integration will have serious consequences for communities. Furthermore, even if federal funds were available to support public health integration with the clinical care system, public health business processes for IT are inadequate to the task of integrating with a fast-paced interoperable national program. Even if funding for grant programs could be found, the process of meeting evolving requirements of meaningful use is ill-suited to traditional Centers for Disease Control and Prevention-funded grant programs.”
Cloud computing may be a solution for public health information systems, stated Lernet and Sundwall. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.
In a fully functioning public health cloud community, state and local health departments would have their choice of certified interoperable integrated applications, the authors opined. "Each jurisdiction could choose its own vendor and migrate annually, promoting competition and further refinement of software. Applications would be able to exchange both case reports and more complex data with each other. State and local jurisdictions could differ but work together through data exchange in the cloud. The limited number of connections would facilitate data exchange. The vendors of these applications would work to meet meaningful use requirements, and software could rapidly evolve."
According to Lenert and Sundwall, the advantages of a cloud approach are significant: public health would have a new computing infrastructure to support connections with healthcare for meaningful use. Remote hosting and shared systems would overcome the problem of insufficient funding and infrastructure for public health systems. Individual jurisdictions could choose their preferred system from a list of certified approved vendors. Systems would be interoperable, facilitating exchange of data between federal, state and local governments, because a uniform certification process would require this.
“Free-market competition that creates large-scale shared cloud-computing resources that are certified for both functionality and interoperability is the only realistic route for public health to achieve universal connectivity to the healthcare system in the meaningful use era,” the authors concluded.
“In light of the absence of new resources to fund public health IT and the economies of scale created by cloud computing, practitioners should choose to move collectively to a new model of shared infrastructure that can keep pace with the evolution of the healthcare system's IT; otherwise it will become more isolated from and less relevant to the clinical care system,” wrote Leslie A. Lenert, MD, and David N. Sundwall, MD, both from the University of Utah, Salt Lake City.
The HITECH Act is intended to enhance reimbursement of healthcare providers for meaningful use of EHRs. This presents both opportunities and challenges for public health departments.
To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health’s IT systems largely lack the capabilities to accept the types of data proposed for exchange.
“The HITECH Act could increase availability of data from the clinical care system to public health, but the needs for expansion of the capabilities [of] public health IT systems are great and the funding to meet these needs is relatively small,” the authors wrote. “Allowing the healthcare system to evolve without public health integration will have serious consequences for communities. Furthermore, even if federal funds were available to support public health integration with the clinical care system, public health business processes for IT are inadequate to the task of integrating with a fast-paced interoperable national program. Even if funding for grant programs could be found, the process of meeting evolving requirements of meaningful use is ill-suited to traditional Centers for Disease Control and Prevention-funded grant programs.”
Cloud computing may be a solution for public health information systems, stated Lernet and Sundwall. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.
In a fully functioning public health cloud community, state and local health departments would have their choice of certified interoperable integrated applications, the authors opined. "Each jurisdiction could choose its own vendor and migrate annually, promoting competition and further refinement of software. Applications would be able to exchange both case reports and more complex data with each other. State and local jurisdictions could differ but work together through data exchange in the cloud. The limited number of connections would facilitate data exchange. The vendors of these applications would work to meet meaningful use requirements, and software could rapidly evolve."
According to Lenert and Sundwall, the advantages of a cloud approach are significant: public health would have a new computing infrastructure to support connections with healthcare for meaningful use. Remote hosting and shared systems would overcome the problem of insufficient funding and infrastructure for public health systems. Individual jurisdictions could choose their preferred system from a list of certified approved vendors. Systems would be interoperable, facilitating exchange of data between federal, state and local governments, because a uniform certification process would require this.
“Free-market competition that creates large-scale shared cloud-computing resources that are certified for both functionality and interoperability is the only realistic route for public health to achieve universal connectivity to the healthcare system in the meaningful use era,” the authors concluded.