NY public health, HIE collaboration drives improvements

A New York public health department has improved its tracking efforts by leveraging the data contained in the regional health information exchange.

The Erie County Department of Health (ECDOH) has linked with HEALTHeLINK, western New York’s clinical information exchange, beginning in 2010. Since then, ECDOH has seen significant improvements in tracking overall public health efforts, especially for sexually transmitted disease (STD) surveillance, treatment and prevention.

Through HEALTHeLINK, ECDOH has been able to more accurately and efficiently improve its STD case reporting and contact tracing system. The percentage of reported chlamydia cases with unknown treatment in Erie County decreased from 46 percent in 2006 to 8 percent in 2012. In addition, HEALTHeLINK use results in more STD contacts brought into care to prevent the spread of disease.

“Chlamydia is a very contagious STD but it’s also very treatable,” said Daniel E. Porreca, HEALTHeLINK’s executive director, speaking to Clinical Innovation + Technology. The ability to know who has tested positive and who has taken the medication aids is effort to prevent spread of the disease.

ECDOH epidemiology staff and disease intervention specialists use HEALTHeLINK to access lab, radiology, medication and demographic data to determine if appropriate STD treatment is administered and to monitor demographic and contact information on STD cases and their partners.

ECDOH has been using HEALTHeLINK since 2010 and in addition to STDs, is also investigating cases of hepatitis B, tuberculosis and rabies within Erie County. 

“Being able to access real time information is translating into improvements for accurate and efficient STD identification, more timely treatment, and a reduction in the spread of the disease. So while we talk about cost savings, which is important, you cannot calculate the cost savings of preventing the spread of diseases,” said Porreca, HEALTHeLINK.

ECDOH staff use HEALTHeLINK’s web-based portals to conduct queries, he said, so there’s no need to synch up internal systems. “They’re logging on in a way similar to a physician in a role that identified them as public health.” All ECDOH needed was internet access.

“As with any organization, fitting it into the workflow is key,” he said. No amount of training can make up for convenience. “To their credit, Eric County saw the value immediately and began using it more and more. They are among our most active users.”

Porreca said he isn’t aware of another public health department connecting to an HIE “in this way and to this extent. The folks at the county and state who have taken it upon themselves to really figure out what is the best use and where can this be best utilized have been trailblazers. Public health has certainly been one of the shining stars relative to the value of a fully functioning HIE.”

Erie is the largest of eight counties covered by HEALTHeLINK. Going forward, Porreca said the organization is trying to communicate to the other counties the potential value of the HIE. More and more are using it, he said, and his goals are “to make sure we’re continuing to be a valuable resource and make sure folks are aware of it.” In the future, ECDOH will use clinical data available through HEALTHeLINK to measure overall population health and target those disease areas that may need further education or access to treatment.

“We’ve been very fortunate here in western New York,” said Porreca. “We have had the support of the healthcare community to get HEALTHeLINK where it is, which is at the point that we have data at critical mass. Without that, there isn’t a whole lot of value we can bring to public health.”