Fed program uses APIs to support public health data exchange

Health agencies were overwhelmed with data flowing in at the start of the pandemic, but now have help from technology.

When the coronavirus hit last year, state and local health departments were suddenly overwhelmed with incoming data and unable to scale their systems for the load.

But a new initiative was stood up, and it serves as an example of how wide varieties of data can be managed to support public health.

The efforts were borne out of the wide range of data flooding in to agencies, said Amy Gleason, team lead of the Pandemic Ready Interoperable Modernization Effort (PRIME), a partnership of the White House’s Digital Service and the Centers for Disease Control and Prevention.

New pop-up point-of-care testing sites, unfamiliar with public health reporting, struggled to report data. It was far from ideal, Gleason said at session last month in the Office of the National Coordinator (ONC) Tech Forum, in a session entitled, “Leveraging Modern APIs to Solve National Needs.”

PRIME conducted an on-the-ground survey last year to get a picture of what was happening, Gleason said. Many COVID-19 testing sites couldn’t send data to multiple connections, and they didn’t have the technological ability to send it in a modern way. They also were more likely to send incomplete data.

With more organizations reporting data, public health departments struggled to validate the increased number of point-to-point interfaces. The data was being transmitted in different formats from schools, nursing homes and jails, Gleason said.

While public health departments were trying to build and maintain individual connections for each sender, they also were likely to miss data from point-of-care sites, Gleason said. In addition, they had homegrown and manual processes to clean, monitor and augment data.

PRIME attacked these problems with three solutions. The first was with data automation, to help senders get and automate their data. The second was through a reporting system called SimpleReport, to help non-traditional sites do COVID testing and report it. Third, PRIME developed a central data hub called ReportStream, a free and open-source platform, which receives the data in any format from senders and converts it to the desired format before sending it on to public health agencies.

The beauty of ReportStream is how it will adapt to the future. It enables public health organizations to move from CSV to HL7 to FHIR APIs when they are ready. “We do the translation in the middle,” Gleason said. “They don’t have to go down to the lowest denominator. We can continue to modernize and continue to move people through.” PRIME launched the hub early this year in a few states. It has since expanded to support more than 19 states, with more signing on each week. At the time of the forum, six more states were in in the process of being added, Gleason said.

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