A recently released report offers tried-and-true approaches that local and state health departments can follow to improve their effectiveness in requesting data from hospitals and delivery systems.
The report, from Johns Hopkins University and the deBeaumont Foundation, aims to aid the departments as they strive to fill in gaps in information they’re gathering to treat asthma.
Public health agencies gather many sources of data that include vital records, lab reports, inspections, public surveys and reporting from clinicians. However, important gaps in understanding the health of populations remain, according to Joshua Sharfstein, MD, associate dean for public health practice and training at the Johns Hopkins Bloomberg School of Public Health, who wrote the report.
“These gaps relate to the fact that many existing data sources provide data, aggregated at a high level infrequently and with a significant delay,” Sharfstein notes. “As a result, public health agencies struggle to respond rapidly and effectively to many important health problems facing their communities.”
For example, the report includes six use cases of how a public health agency can use electronic health information to better treat childhood asthma; offers guidance on the legal underpinnings of sharing data under the HIPAA law; and describes how to use data to advance community health.
The six use cases in the report cover assessing if childhood asthma is rising or falling in a community or region, housing conditions that trigger asthma, the usefulness of home visits, checking the asthma care plan, ensuring asthma medication prescriptions are being filled, and whether the overall program is reducing illness from asthma.
The use case on housing conditions assesses environment conditions that can trigger asthma attacks, such as pests and mold, and how health department can identify certain residential blocks and conduct home visits to understand the environment and consider interventions.
To accomplish this, a health department can request a data file from hospitals in the county with information on persons under age 21 diagnosed with asthma during an emergency department visit or hospitalization. The file should include such information as address, date, age, gender and race or ethnicity. The file should not list the name, Social Security number and other sensitive identifying information, according to Sharfstein.
Departments should request the file weekly and analyze the data on a weekly basis to pinpoint geographic regions of highest risks such as rodents, external air quality or smoking in homes.
Health departments then can promote smoking cessation programs, small home repairs and access to legal aid for renters to obtain corrective actions by landlords. Use of geocoded data can aid in creating a “heatmap” of areas in a city with high rates of asthma.
Each use case in the report includes an analysis of how health departments can take proactive measures while remaining in compliance with HIPAA requirements. To aid health departments, hospitals are permitted under HIPAA to share data to identify geographic areas of highest risk.
“In this use case, the health department has clearly articulated a need for health information, including geographic data related to a public health activity—assessment of home hazards related to asthma and the provision of remedial services to address risks,” says Sharfstein. “This clear articulation gives the health department the legal authority to request and receive protected health information from local hospitals and healthcare providers under HIPAA.”
All six use cases are available here.
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